Objective To investigate the cardioprotective effects of blood perfusion(HP)com-bined with continuous veno-venous hemofiltration(CVVH)in patients with acute organophospho-rus pesticide poisoning (AOPP).Methods On the basis of conventional treatment,24 patients with AOPP were randomly treated with HP alone(control group,n=13)or in combination with CVVH(observation group,n=11).Clinical efficacy,myocardial injury and prognosis were com-pared between the two groups.Results Compared with control group,cholinesterase activity re-covery time,coma time,mechanical ventilation time,hospital stay,atropine dosage,incidence of ar-rhythmia,and mortality rate significantly decreased in observation group(P<0.05).After treat-ment for 72 hours,compared with control group,CK-MB and BNP decreased and LVEF increased in observation group(P<0.05 ).Conclusion The combination of HP and CVVH can enhance therapeutic efficacy,protect myocardium and improve prognosis in patients with AOPP.%目的 探讨血液灌流(HP)联合连续性静脉-静脉血液滤过(CVVH)对急性有机磷农药中毒(AOPP)的心肌保护作用.方法 将24例AOPP患者按随机数字表法分为观察组11例和对照组13例.2组均给予基础治疗,对照组在基础治疗上给予HP治疗,观察组在基础治疗上采用HP联合CVVH治疗.比较2组的临床疗效、心肌损伤情况及预后.结果 观察组的胆碱酯酶(CHE)活性恢复时间、昏迷时间、机械通气时间、住院时间均短于对照组,阿托品用量少于对照组(均P<0.05).观察组治疗72 h后的肌酸磷酸激酶同工酶(CK-MB)、脑纳肽(BNP)低于对照组,左室射血分数(LVEF)高于对照组(均P<0.05).观察组心律失常的发生率和病死率均低于对照组(均P<0.05).结论 HP联合CVVH治疗不仅能够提高AOPP患者的临床治疗效果,而且具有心肌保护作用,能够显著改善患者的预后.
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