| Background:Organophosphorus pesticides in agriculture and horticul-ture is the country most widely used pesticides and herbicides, pesticide poisoning and food residues are the main types. Acute organophosphorus pesticide poisoning is one of the most common acute poisoning, ranking the first in all kinds of pesticide poisoning and acute chemical poisoning. In recent years, in the development of society and industrial and agricultural production,.Production of intoxication,wrongly,or individual acts of suicide are increasing in the clinical, Annual growth trend in the number of poisoning and hazardous area. In recent years in order to overcome pest resistance, increased pesticide efficacy, addition of organic phosphorus pesticide mixed with other pesticide use, so the majority of pesticide toxicity to increase, so that diagnosis and treatment of patients with pesticide poisoning more difficult. Patients with acute organophosphorus pesticide poisoning disease potential danger, if not rescued or improper treatment, patients can die in the near future. The average fatality rate currently around 10% in AOPP, mostly patients with severe poisoning. Leading causes of death include pulmonary edema, respiratory failure, shock,acute cerebral edema,toxic myocarditis,electrolyte disturbance organ failure;treatment of acute organophosphate poisoning is mainly to take comprehensive measures, including the removal of toxic pesticides and to prevent continued absorption, early and reasonable Application effects of drug detoxification, and give symptomatic and supportive treatment. Current mild, moderate patients with poisoning are in a high cure rate, but high dose organophosphate pesticides caused severe organophosphorus pesticide poisoning, treatment is still not optimistic. Therefore, the new treatment methods or therapies in the treatment is necessary.Goal:In the treatment of severe organophosphorus poisoning patients, the conventional treatment based added the use of blood perfusion and Xuebijing injection to explore the role of both in treatment.Methods:We chose the higher rate of organophosphate poisoning admitted to the hospital for the observation of a subsidiary point, the observation period (June 2008～December 2009) Income House of acute severe organophosphorus pesticide poisoning patients, based on"occup-ational acute with phosphorus insecticide agent poisoning diagnostic criteria"(GBZ 82-2002) diagnosis meet the criteria of severe poisoning, and the exclusion of important subjects included a history of the disease. All subjects in accordance with the random number table, into the conventional therapy group (A group) 18 cases; conventional therapy add blood perfusion group (B group) 19 cases; conventional treatment add Xuebijing and blood perfusion group (C group) 18 cases. Unified by the study design for clinical treatment of patients and clinical observation. Observation Form in accordance with documented cases of treatment of disease evolution, until discharge.Result:We collected a total of 55 patients eligible,21 males and 34 females, aged 14 to 69 years, mean age 41.5±15 years. There were no statistical significance between groups in gender, age, medication volume, poison to visiting time, and other types of pesticide poisoning. (P＞0.05). Two groups of patients after blood perfusion enzyme, ALT, amylase, creatinine Dengjun decreased significantly (P＜0.05), C group was lower than B group (P＜0.05), suggest blood perfusion can protect the liver, renal, cardiac function, also this protective effect with Xuebijing become more clear. The blood gas analysis and cholinesterase activity group situation:A group no significant changes in arterial partial pressure of oxygen, B group the partial pressure of oxygen was significantly higher than the A group after 7 days (P＜0.05), indicates that early application of blood perfusion AOPP may prevent further damage to the lungs, and the symptoms under the protection of the xuebijing restore more obvious in the blood after 7 days. Cholinesterase change:A group of 7 days CHE1267±47.8u/L, blood perfusion group after 7 days (2638±52.36) was significantly higher than conventional treatment group, plus Xuebijing (3968±52.4) was more significant. Among the three groups on cholinesterase recovery time, total hospital stay, there are obvious differences in cure rate, but total hospital costs were no significant differences (P＞0.05).Conclusion:1,this experiment can be seen directly on the blood perfusion of organophosphorus pesticides with adsorption in patients with severe AOPP treatment can shorten the recovery time of cholinesterase, AChE recovery rate increase,to a certain extent.2, Hemoperfusion treatment of acute severe organophosphorus pesticide poisoning can reduce mortality and duration to improve the clinical efficacy:HP is a safe, minor side effects of treatment.3, this study initially confirmed Xuebijing in the role of severe organophosphorus poisoning treatment, Xuebijing will be a net injection for acute severe organophosphorus pesticide poisoning patients do have to protect organ function and improve prognosis, improve the success rate results.4, Combination therapy may reduce the patient length of stay, but the hospital cost nearly the same as the total cost of the treatment of non-HP.
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