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目的 探讨血液灌流对有机磷中毒患者血清胆碱酯酶活性的影响及毒物清除效果.方法 选择中国医科大学附属盛京医院2017年1月至2019年1月收治的有机磷中毒患者60例,采用随机数字表法分为观察组30例、对照组30例.对照组采用常规治疗,观察组在常规治疗基础上应用血液灌流治疗,比较两组治疗效果.结果 观察组机械通气时间、意识清醒时间分别为(3.07±1.14)d、(1.42±0.37)d,均明显短于对照组的(4.15±1.22)d、(2.01±0.58)d(t=3.543、4.697,均P<0.05);观察组阿托品用量[(252.57±28.44)mg]明显少于对照组[(282.61±29.82)mg](t=3.993,P<0.05).治疗12 h、24 h后,观察组胆碱酯酶活性分别为(1128.64±152.49)U/L、(1422.08±184.68)U/L,均高于对照组的(912.73±144.61)U/L、(1165.32±173.27)U/L(t=5.627、5.553,均P<0.05).治疗1 d、3 d后,观察组有机磷毒物浓度分别为(1.08±0.30)mg/L、(0.62±0.18)mg/L,明显低于对照组的(1.32±0.35)mg/L、(0.84±0.27)mg/L,均差异有统计学意义(t=2.852、3.713,均P<0.05).观察组反跳、中间综合征、多器官衰竭发生率分别为3.33％(1/30)、6.67％(2/30)、13.33％(4/30),均低于对照组的23.33％(7/30)、23.33％(7/30)、36.67％(11/30)(χ2=5.192、3.278、4.356,均P<0.05).结论 血液灌流对有机磷中毒患者提高血清胆碱酯酶活性和清除血液毒物浓度效果明显,值得在临床上推广应用.“,”Objective To investigate the effect of hemoperfusion (HP) on the activity of ChE in blood ofpatients with organophosphorus poisoning,and its toxicant clearance effect.Methods From January 2017 to January 2019,60 patients with organophosphorus poisoning in Shengjing Hospital Affiliated to China Medical University were divided into observation group and control group according to random number table method , with 30 cases in each group.The control group was treated with routine treatment ,while the observation group was treated with HP on the basis of routinetreatment.Thetherapeuticeffectsof thetwogroupswerecompared.Results Thedurationof mechanical ventilation and conscious awakening in the observation group were (3.07 ±1.14) d and (1.42 ±0.37) d,respectively, which were significantly shorter than those in the control group [(4.15 ±1.22) d,(2.01 ±0.58)d](t=3.543, 4.697,all P<0.05).The dosage of atropine in the observation group [(252.57 ±28.44) mg] was significantly less than that in the control group [(282.61 ±29.82)mg](t=3.993,P<0.05).The activity of cholinesterase after 12 h and 24 h of treatment was significantly higher than those before treatment (all P<0.05).After 12 h and 24 h of treatment,the cholinesterase activities in the observation group were (1128.64 ±152.49) U/L and (1422.08 ± 184.68)U/L,respectively,which were higher than those in the control group[(912.73 ±144.61) U/L and (1165.32 ± 173.27)U/L](t=5.627,5.553,all P<0.05).After 1 d and 3 d of treatment,the concentrations of organophosphorus poisons in the observation group were (1.08 ±0.30) mg/L and (0.62 ±0.18) mg/L,respectively,which were significantly lower than those in the control group[(1.32 ±0.35)mg/L and (0.84 ±0.27)mg/L](t =2.852, 3.713,all P<0.05).The incidences of rebound ,intermediate syndrome and multiple organ failure in the observation group were 3.33％(1/30),6.67％(2/30) and 13.33％(4/30),respectively,which were lower than those in the control group［23.33％(7／30),23.33％(7／30),36.67％(11／30)］(χ2 ＝5.192,3.278,4.356,all P ＜0.05).Conclusion HP has obvious effect on the activity of ChE and the concentration of blood poisons in patients with organophosphorus poisoning.It is worthy of popularizing and applying in clinic.