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Clinical evaluation of the efficacy of emergency bedside hemoperfusion in acute severe organophosphorus pesticide poisoning |
SHI Jia-quan LI Guo-xian CHEN Bin HUANG Zuo-cai JIANG Fu-chang |
Department of Emergency Medicine,People′s Hospital of Meizhou City in Guangdong Province,Meizhou 514031,China |
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Abstract ObjectiveTo evaluate the clinical efficacy of acute severe organophosphorus pesticide poisoning by emergency bedside hemoperfusion.MethodsA total of 70 patients with acute severe organophosphorus pesticide poisoning from January 2013 to February 2017 were selected as the study subjects,and were randomly divided into the conservative internal medicine group and the hemoperfusion group according to the random number table methods,with 35 patients in each group.The conservative internal medicine group was given routine internal medical methods for treatment,and the hemoperfusion group was further given emergency bedside hemoperfusion rescue on the basis of the conservative internal medicine group.The total treatment effective rate of acute severe organophosphorus pesticide poisoning,the serum cholinesterase levels,atropine dosage,coma time,time of ventilator use after rescue,and the incidence rate of myasthenia gravis in the middle phase were compared between the two groups.ResultsThe total effective rate in the hemoperfusion group(97.14%)was higher than that in the conservative internal medicine group(77.14%),and the difference was statistically significant(P<0.05).The serum cholinesterase levels([25.13±8.41]U/L)and the dosage of atropine([235.51±52.61]mg)in the hemoperfusion group after rescue were lower than those([15.39±4.13]U/L,[387.35±73.57]mg)in the conservative internal medicine group,the coma time([10.62±1.21]h)and the time of ventilator use([76.51±11.61]h)were better than those([23.61±2.68]h,[157.35±22.57]h)in the conservative internal medicine group,with significant difference(P<0.05).The incidence rate of myasthenia gravis in the middle phase in hemoperfusion group was 8.57%,which was lower than 22.86%in the conservative internal medicine group,and the difference was statistically significant(P<0.05).ConclusionThe clinical efficacy of acute severe organophosphorus pesticide poisoning by emergency bedside hemoperfusion rescue is effective,which can improve the clinical symptoms,shorten the time of coma and the time of ventilator use,reduce the dosage of atropine,restore serum cholinesterase levels,and reduce the occurrence of negative prognosis,which is worthy of promotion.
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