摘要
目的评估急性重度有机磷农药中毒并发酸中毒治疗中应用血浆置换(PE)的价值。方法纳入68例急性重度有机磷农药中毒并发酸中毒患者,用随机数字表法分为对照组(34例,选择常规治疗)、观察组(34例,在对照组基础上进行血浆置换治疗)。比较两组并发症发生率及不同时间点动脉血pH值、碳酸氢根(HCO_(3)^(-))、碱剩余(BE)、乳酸、乙酰胆碱酯酶(AChE)。结果观察组并发症发生率稍低于对照组,但对比差异无统计意义(2.94%vs.11.76%,P>0.05)。治疗6、12、48 h后,两组动脉血pH值均较治疗前升高,但组间、组内对比差异无统计学意义(P>0.05)。治疗6、12、48 h后,观察组HCO_(3)^(-)分别为(19.22±0.28)、(22.28±0.64)、(23.54±0.64)mmol/L,BE分别为(-3.00±0.14)、(-0.76±0.11)、(0.85±0.28)mmol/L,AChE分别为(756.11±14.23)、(1076.62±12.64)、(1295.24±113.62)U/L,乳酸分别为(2.54±0.52)、(1.97±0.42)、(1.70±0.24)mmol/L;治疗6、12、48 h后,对照组HCO_(3)^(-)分别为(18.87±0.26)、(20.81±0.61)、(22.91±0.49)mmol/L,BE分别为(-5.55±0.46)、(-2.02±0.64)、(-0.43±0.41)mmol/L,AChE分别为(698.89±14.68)、(827.62±14.66)、(1103.14±14.94)U/L,乳酸分别为(2.85±0.46)、(2.36±0.24)、(1.88±0.46)mmol/L。治疗6、12、48 h后,观察组HCO_(3)^(-)、BE、AChE高于对照组,乳酸低于对照组(P<0.05)。结论急性重度有机磷农药中毒并发酸中毒治疗中应用血浆置换可提高毒物清除能力,改善整体预后。
Objective To evaluate the value of plasma exchange(PE)in the treatment of acute severe organophosphorus pesticide poisoning complicated with acidosis.Methods A total of 68 patients with acute severe organophosphorus pesticide poisoning complicated with acidosis were enrolled.They were divided into two groups using a random number table method:the control group(34 cases,received conventional treatment)and the observation group(34 cases,received plasma exchange treatment based on the control group).The complication rate,arterial blood pH value,bicarbonate(HCO_(3)^(-)),base excess(BE),lactic acid and acetylcholinesterase(AChE)at different time points were compared between the two groups.Results The incidence of complications in the observation group was slightly lower than that in the control group,but the difference was not statistically significant(2.94%vs.11.76%,P>0.05).At 6,12,and 48 h post-treatment,arterial blood pH levels increased in both groups compared to pre-treatment levels.However,no statistically significant differences were observed between groups or within groups(P>0.05).At 6,12,and 48 h post-treatment,HCO_(3)^(-)levels in the observation group were(19.22±0.28),(22.28±0.64),and(23.54±0.64)mmol/L respectively,BE were(-3.00±0.14),(-0.76±0.11),and(0.85±0.28)mmol/L respectively,AChE were(756.11±14.23),(1076.62±12.64),and(1295.24±113.62)U/L respectively,and lactate were(2.54±0.52),(1.97±0.42),and(1.70±0.24)mmol/L respectively.At 6,12,and 48 h post-treatment,HCO_(3)^(-)in the control group were(18.87±0.26),(20.81±0.61),and(22.91±0.49)mmol/L respectively,BE were(-5.55±0.46),(-2.02±0.64),and(-0.43±0.41)mmol/L respectively,AChE were(698.89±14.68),(827.62±14.66),and(1103.14±14.94)U/L respectively,and lactate were(2.85±0.46),(2.36±0.24),and(1.88±0.46)mmol/L respectively.At 6,12,and 48 h post-treatment,HCO_(3)^(-),BE and AChE in the observation group were higher than those in the control group,while the lactic acid was lower than that in the control group(P<0.05).Conclusion Plasma exchange can enhance toxin clearance capacity and improve overall prognosis in the treatment of acute severe organophosphorus pesticide poisoning complicated with acidosis.
作者
蔡俊林
饶丽霞
朱义洪
CAI Jun-lin;RAO Li-xia;ZHU Yi-hong(Putian Emergency Center,Putian 351100,China)
出处
《中国现代药物应用》
2026年第4期26-30,共5页
Chinese Journal of Modern Drug Application
关键词
血浆置换
急性重度有机磷农药中毒
酸中毒
疗效
Plasma exchange
Acute severe organophosphorus pesticide poisoning
Acidosis
Efficacy
