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| Clinical Observation of Continuous Veno-Venous Hemofiltration Combined with Hemoperfusion in The Treatment of Severe Acute Organophosphorus Poisoning |
| QI Xiaoli, XIONG Mingfen, TAO Ning, et al |
| Suining Central Hospital, Sichuan Suining 629000, China |
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Abstract Objective: To observe the clinical efficacy of continuous veno-venous hemofiltration (CVVH) combined with hemoperfusion (HP) in the treatment of severe acute organophosphorus poisoning (ASOPP). Methods: The data of 126 patients with ASOPP were retrospectively analyzed. According to the treatment methods, the patients were divided into CVVH+HP group (n=60) and HP group (n=66). The efficacy and treatment were observed. Serum cholinesterase (CHE) level was recorded before treatment (T1) and at 4h (T2), 24h (T3) and 72h (T4) after treatment. The differences of serum inflammatory factors [interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10(IL-10), tumor necrosis factor-α (TNF-α)] and liver-kidney injury related indicators [cystatin C (CysC), prealbumin (PA), high mobility group protein B1 (HMGB1)] were compared between the two groups at T1 and T3, and the occurrence of complications was observed. Results: The cure rate was 93.33% in CVVH+HP group, which was higher than 78.79% in HP group (P<0.05). There was no statistical significance in the incidence rate of rebound between the two groups (P>0.05). The dosages of atropine and pralidoxime chloride with (143.37±18.72)mg and (10.28±2.62)g in CVVH+HP group were less than (154.18±21.47)mg and (19.57±4.31)g in HP group (all P<0.05). The coma time and hospital stay in CVVH+HP group were (13.38±3.41)h and (7.26±1.58)d, which were shorter than (22.15±4.14)h and (8.42±1.74)d in HP group (all P<0.05). At T2~T4, the level of serum CHE in the two groups was increased gradually, and the increase in CVVH+HP group was greater than that in HP group (all P<0.05). At T1, the levels of serum IL-1β, IL-6, IL-10 and TNF-α and serum CysC, PA and HMGB1 revealed no statistical differences between the two groups (P>0.05). The differences of serum IL-1β, IL-6, IL-10, TNF-α, CysC, PA and HMGB1 at T1-T3 were greater in CVVH+HP group than those in HP group (all P<0.05). There was no statistical difference in the occurrence of complications between the two groups (P>0.05). Conclusion: Compared with HP alone, CVVH+HP for ASOPP can enhance the cure rate, improve the treatment, promote the recovery of serum CHE activity, alleviate the inflammatory response and relieve the organ damage, and it has good safety and certain advantages.
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2024, Vol. 30 
