Abstract
Objective To investigate the clinical efficacy of hemoperfusion(HP)combined with continu-ous veno-venous hemodiafiltration(CVVHDF)in the treatment of acute severe organophosphorus pesticide poisoning(AOPP).Methods A retrospective analysis was conducted on the clinical data of 68 patients with acute severe AOPP who were treated at the People's Hospital of Songtao Miao Autonomous County from January 2022 to October 2024.Pa-tients were divided into two groups based on treatment methods:the control group(35 cases)and the intervention group(33 cases).The control group received conventional treatments,including early gastric lavage,catharsis,detoxification,respiratory support,and circulatory support.The intervention group received HP combined with CVVHDF in addition to the conventional treatments.Baseline characteristics,primary outcomes(overall mortality,ICU length of stay,total hospi-tal stay),secondary outcomes(complication incidence,time to regain consciousness after admission,duration of invasive mechanical ventilation,time to recovery of cholinesterase to normal),and laboratory parameters(oxygenation index-[OI],procalcitonin[PCT],lactate[Lac],alanine aminotrans-ferase[ALT],aspartate aminotransferase[AST],total biliru-bin[TBIL],creatinine[Cr],activated partial thromboplastin time[APTT],prothrombin time[PT],D-dimer,C-reactive protein[CRP],interleukin-6[IL-6])were compared between the two groups.Results The overall mortality rate in the intervention group was lower than that in the control group(6.06％vs.28.57％),with a statistically significant difference(P＜0.05).The intervention group had shorter ICU stay,total hospital stay,time to regain consciousness,duration of invasive mechanical ventilation,and time to recovery of cholinesterase com-pared to the control group(P＜0.05).The incidence of complications in the intervention group was lower than that in the control group.There were no statistically significant differences between the two groups in laboratory parameters before treatment(P＞0.05).After 3 days of treatment,the intervention group showed significantly higher OI and lower levels of Lac,ALT,AST,TBIL,Cr,PT,APTT,D-dimer,PCT,CRP,and IL-6 compared to the control group,with statistically significant differences(P＜0.05).Conclusion The early application of HP combined with CVVHDF in the treatment of acute severe AOPP is superior to conventional pharmacological therapy.It reduces mortality,shortens hospital stay,decreases complica-tion incidence,and improves both clinical symptoms and laboratory parameters.关键词
血液灌流/连续性静脉-静脉血液透析滤过/有机磷农药中毒Key words
Hemoperfusion/Continuous Veno-Venous Hemodiafiltration/Organophosphorus pesticide poisoning分类
农业科技
