Influence of hemoperfusion frequency on therapeutic effect and prognosis of patients with severe acute organophosphorus poisoning
10.3969/j.issn.1008-9691.2013.05.011
- VernacularTitle:血液灌流治疗次数对重度急性有机磷农药中毒疗效和预后的影响
- Author:
Yu DU
;
Yi MOU
;
Liqiang ZHAO
- Publication Type:Journal Article
- Keywords:
Hemoperfusion;
Acute organophosphorus poisoning,severe;
Treatment times
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2013;(5):289-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the correlations between hemoperfusion(HP) times and therapeutic effects/prognosis in patients with severe acute organophosphorus poisoning(AOPP). Methods According to the frequency of HP,82 patients with severe AOPP were divided into three groups:non HP(25 cases),HP1(27 cases) and HP2(30 cases)groups. The non HP group received only routine treatment,on the basis of routine treatment,the HP1 group accepted once HP within 12 hours after poisoning and the HP2 group underwent twice or more times of HP,the interval between each time being 24 hours. The comparisions of clinical indexes,incidences of complications and rates of mortality among the three groups were performed. Results With the increase of HP times,the dosages of atropine and pralidoxime chloride were significantly reduced,the times of serum cholinesterase(ChE)activity recovery,consciousness recovery,hospitalization and mechanical ventilation were significantly shortened,the score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in 48 hours after admission,incidence of complications and mortality were evidently decreased(all P<0.05). Compared with those in HP1 group,the dosages of atropine(mg:164.57±68.82 vs. 256.81±97.06)and pralidoxime chloride(mg:6.95±1.40 vs. 8.76±1.64) in HP2 group were significantly reduced,the times of ChE activity recovery(day:9.03±2.46 vs. 10.96±3.44), consciousness recovery(hour:23.83±6.29 vs. 39.93±8.24),hospitalization(hour:9.57±2.39 vs. 11.52±3.02) and mechanical ventilation(hour:40.50±16.55 vs. 65.74±18.88)in HP2 group were significantly shortened;APACHEⅡscore during 48 hours after admission(11.97±3.47 vs. 14.26±2.88)was obviously decreased,and the incidences of complications,such as intermediate syndrome(10.0% vs. 18.5%),rebound phenomenon(3.3% vs. 25.9%),arrhythmia(13.3%vs. 44.4%),multiple organ dysfunction syndrome(MODS,6.7%vs. 29.6%)and mortality rate(6.7% vs. 18.5%)in HP2 group were markedly decreased(all P<0.05). Conclusion It is recommendable that combined with routine treatment,early and multiple HP application would enhance the therapeutic effect and decrease the mortality in patients with severe AOPP.
