摘要
目的:探讨加味大承气汤鼻饲配合树脂血液灌流对急性有机磷中毒(AOPP)患者肾功能及预后的影响。方法:选取本院2016年4月~2019年4月收治的90例急性AOPP患者,随机数表法分为观察组和对照组,各45例。两组患者在接受有机磷中毒常规治疗的基础上,分别给予加味大承气汤鼻饲联合树脂血液灌流和单一树脂血液灌流治疗。比较两组的阿托品用量、意识清醒时间、排便时间、症状消失时间、住院时间,测定两组患者治疗前后的胆碱酯酶(CHE)、谷丙转氨酶(ALT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、总蛋白(TP)、尿素氮(BUN)、肌酐(Cr)、尿酸(Ua)水平,并比较两组治疗过程中相关并发症的发生率。结果:观察组患者的阿托品总用量、患者清醒时间、排便时间、症状完全消失时间及住院时间等一般情况指标均显著低于对照组(P<0.05);治疗后,两组CHE明显升高,ALT、CK、LDH明显降低,且观察组各指标升高或降低的幅度显著高于对照组(P<0.05);治疗后,两组TP、BUN、Scr、Ua等肾功能指标明显降低,且观察组各指标较对照组显著低(P<0.05);观察组相关并发症的发生率为15.56%,低于对照组的35.56%,差异具有统计学意义(P<0.05)。结论:加味大承气汤鼻饲联合树脂血液灌流治疗急性有机磷中毒,可减少阿托品用量,有效改善患者的相关酶学指标和肾功能水平,促进患者肾功能的恢复,降低相关并发症的发生率,值得临床推广应用。
Objective: To investigate the effect of Modified Dachengqi Decoction by nasal feeding combined with resin hemoperfusion on renal function and prognosis for patients with acute organophosphorus poisoning(AOPP). Methods: Ninety patients with AOPP who were admitted to the hospital between April 2016 and April 2019 were selected and divided into observation group and controlled group by the random number table method, with 45 cases in each group. On the basis of routine treatment of organophosphorus poisoning, the two groups were treated with Modified Dachengqi Decoction combined with by nasal feeding combined with resin hemoperfusion and simile resin hemoperfusion. The dosage of atropine, awaketime, defecation time, symptom disappearance time and hospital stay were compared between the two groups. The cholinesterase(CHE),alanine aminotransferase(ALT),creatine kinase(CK),lactate dehydrogenase(LDH),total protein(TP),blood urea nitrogen(BUN),creatinine(Cr) and uric acid(Ua) levels in both groups were determined before and after treatment. The incidence of related complications during treatment were compared between the two groups. Results: The total dosage of atropine, awake period, defecation time, symptom complete disappearance time and hospital stay of the observation group were significantly lower/shorter than the controlled group(P<0.05). After treatment, CHE in both groups significantly increased, while ALT,CK and LDH decreased significantly. Besides, and the increase or decrease of each index in the observation group was significantly greater than that in the controlled group(P<0.05). After treatment, the renal function indexes TP,BUN,Scr and Ua in both groups decreased significantly, and the above indexes in the observation group were significantly lower than the controlled group(P<0.05). The incidence of related complications in the observation group(15.56%) was lower than that in the controlled group(35.56%)(P<0.05). Conclusion: The application of of Modified Dachengqi Decoction by nasal feeding combined with resin hemoperfusion in the treatment of AOPP can reduce the dosage of atropine, effectively improve the relevant enzymatic indexes and renal function in patients, promote the recovery of renal function, and reduce the incidence of related complications.
作者
谭辉
段颖
伏晓琳
张怡
TAN Hui;DUAN Ying;FU Xiaolin(Department of Critical Care Medicine,Xianyang Central Hospital,Xianyang Shaanxi 712000,China)
出处
《四川中医》
2021年第1期110-113,共4页
Journal of Sichuan of Traditional Chinese Medicine
关键词
急性有机磷中毒
加味大承气汤
血液灌流
肾功能
预后
Acute organophosphorus poisoning
Modified Dachengqi Decoction
Hemoperfusion
Renal function
Prognosis
