The Clinical Study Of Hemoperfusion On Acute Severe Organic Phosphorus Poisoning

Objective:To observe the blood perfusion (hemoperfusion, HP) technology clinical curative effect for the treatment of acute severe organophosphorus pesticide poisoning.Methods:In January2012to October2013during the period of jining medical college affiliated hospital treated84patients with ASOPP,35male and female in49cases, aged16-75, divided into blood perfusion group (HP group,44cases) and conventional treatment group (HP group,40cases). Conventional treatment group patients were performed after admission by gastric lavage, catharsis, rehydration diuretic, application of atropine, long ning and pralidoxime chloride, and protect liver protecting stomach suit the support treatment. HP group on the basis of routine therapy in two hours after admission of a blood perfusion treatment, compared two groups of curative effect, and according to the cases of treatment of watch list detailing the illness until the evolution process of the hospital. Record contents:the patient’s general condition, type of drug poisoning, poison drug dosage, treatment time to start, long ning dosage, the dosage of atropine and pralidoxime chloride dosage, coma, respiratory failure cases, breathing machine application time, cholinesterase activity, blood routine and biochemical indexes, APACHE Ⅱ score and complications. To observe the end died in hospital and patient prognosis as the dependent variable, with clinical observation indexes as the independent variable in Logistic regression analysis, analysis of factors affecting the prognosis of patients with dangerous. At the same time observe the blood perfusion group of patients with HP related complications.Results:Conventional treatment group compared with HP group, gender, poisoning the dosage, the types of poisoning of pesticide no difference (P>0.05). Between the two groups of long ning dosage, dosage of atropine and pralidoxime chloride dosage, coma time, mechanical ventilation time and treatment time to start, hospitalization days, cholinesterase activity, complication rates in comparison, the difference was statistically significant (P<0.05). Logistic regression analysis showed that age, drug dosage, treatment time to start by taking poison, cholinesterase activity, complications and APACHEII scores and whether line blood perfusion is closely related to the prognosis of patients (P<0.05). HP group no obvious complications caused by blood perfusion, only2cases with slight drop in blood pressure,1case of thrombocytopenia,1case of a drop in number of white blood cells.Conclusions:1.HP treatment ASOPP can shorten the duration of coma, cholinesterase shorten recovery time and shorten the duration and reduce the incidence of respiratory failure in patients with shortened duration of mechanical ventilation, improved clinical efficacy, fewer side effects, is a safe and effective rescue treatment.2.HP ASOPP can significantly reduce the incidence of patients with IMS.3.HP ASOPP can significantly reduce complications and reduce mortality and improve the prognosis, is an independent risk factor ASOPP prognosis.