The clinical study of sequential therapy by intravenous fat emulsion and hemoperfusion in patients with severe organophosphorus pesticide poisoning / 中国医师进修杂志

ABSTRACT

Objective To study the clinical effect of sequential therapy by intravenous fat emulsion and hemoperfusion in patients with severe organophosphorus pesticide poisoning. Methods Seventy-two patients with severe organophosphorus pesticide poisoning were selected, and the patients were divided into sequential therapy group (36 cases) and conventional therapy group (36 cases) by random digits table method. All the patients were given conventional therapy including gastrolavage, purgation, fluid infusion, atropine, pralidoxime chloride, anti- infection, breath support and hemoperfusion. The patients in sequential therapy group were given intravenous fat emulsion before hemoperfusion. The clinical effect was compared between 2 groups. Results There were no statistical differences in the serum cholinesterase activity on admission and in the first day after treatment between 2 groups (P>0.05). The serum cholinesterase activities in the second, third and seventh day after treatment in sequential therapy group were significantly higher than those in conventional therapy group (456.3 ± 45.6) U/L vs. (391.3 ± 39.8) U/L, (862.3 ± 96.2) U/L vs. (614.7 ± 78.5) U/L and (1950.9 ± 366.7) U/L vs. (1543.6 ± 285.9) U/L, and there were statistical differences (P<0.05). The total doses of atropine applied and length of stay in sequential therapy group were significantly less than those in conventional therapy group (85.4 ± 36.2) mg vs. (104.7 ± 45.3) mg and (10.5 ± 4.2) d vs. (13.6 ± 6.2) d, and there were statistical differences (P<0.05). The recovery rate in sequential therapy group was significantly higher than that in conventional therapy group97.2%(36/36) vs. 80.6%(29/36), and there was statistical difference (P<0.05). Conclusions Sequential therapy by intravenous fat emulsion and hemoperfusion can improve the serum cholinesterase activity, and decrease the total dose of atropine in patients with severe organophosphate pesticide poisoning.