目的：分析血液灌流与血浆置换联合对老年重度有机磷中毒患者的治疗效果。方法整群选取2013年8月―2015年7月厦门解放军第174医院急诊科收治的62例老年重度有机磷中毒患者按随机数字表法分成观察组和对照组各31例。对照组单纯采用血液灌流治疗,观察组采用血液灌流联合血浆置换进行治疗。对比两组治疗前、后胆碱酯酶(ChE﹚、B型钠尿肽(BNP﹚、C反应蛋白(CRP﹚、肿瘤坏死因子(TNF﹚-α的水平及并发症发生率、死亡率。结果观察组治疗前ChE、BNP、CRP、TNF-α水平分别为(21.56±6.52﹚%、(22.54±4.29﹚pg/mL、(16.99±3.56﹚mg/L、(31.58±4.59﹚ng/L,与对照组差异无统计学意义(P>0.05﹚；观察组治疗后ChE水平为(43.81±7.34﹚%,明显高于对照组的(38.26±7.55﹚%(P<0.05﹚；观察组治疗后BNP、CRP、TNF-α水平(17.04±3.28﹚pg/mL、(7.32±1.27﹚mg/L、(25.47±3.56﹚ng/L,均明显低于对照组的(19.58±3.65﹚pg/mL、(8.46±1.25﹚mg/L、(28.38±3.25﹚ng/L(P<0.05﹚；观察组并发症发生率和死亡率分别9.68%、12.9%,均明显低于对照组的32.26%、38.71%(c<0.05﹚。结论血液灌流与血浆置换联合应用能有效的改善老年重度有机磷中毒患者的生化指标,并降低并发症和死亡率。%Objective Observe hemoperfusion and plasma exchange in elderly patients with severe poisoning organophos-phate treatment.Methods Group select August 2013 to April 2015 62 elderly patients with severe organophosphate poison-ing patients admitted by randomly divided into observation group and the control group 31 cases.Compare the two groups before and after treatment cholinesterase (ChE), B-type natriuretic peptide (BNP), C-reactive protein (CRP), tumor necrosis factor (TNF)-αlevels of morbidity and mortality. Results Observation group before treatment ChE, BNP, CRP, TNF-α lev-els (21.56±6.52)%, respectively, (22.54±4.29) pg/mL, (16.99±3.56) mg/L, (31.58±4.59) ng/L, and the control group had no significant difference (P>0.05); the observation group after treatment ChE levels (43.81±7.34)%, significantly higher than that (38.26±7.55)% (P<0.05); the observation group after treatment BNP , CRP, TNF-α levels (17.04±3.28) pg/mL, (7.32± 1.27) mg/L, (25.47±3.56) ng/L, significantly lower than the control group (19.58±3.65) pg/mL, (8.46±1.25) mg/L, (28.38±3.25) ng/L (P<0.05);the observation group morbidity and mortality rates were 9.68%, 12.9%, significantly lower than the 32.26%in the control group, 38.71% (P<0.05). Conclusion Hemoperfusion and plasmapheresis combined can effectively improve biochemical indicators in elderly patients with severe organophosphate poisoning, and reduce morbidity and mortality.
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