The effect of standardized emergency treatment combined with early hybrid blood purification on the treatment of acute organophosphorus poisoning

LIU Hui-min; LI Li-na; SHAO Biao; CHEN Gang; YIN Na

doi:10.16048/j.issn.2095-5561.2024.01.07

Abstract：Objective To explore the application effect of standardized emergency treatment combined with hybrid blood purification in the early comprehensive treatment of acute organophosphorus pesticide poisoning(AOPP). Methods A total of 103 AOPP patients admitted to the Kunming First People's Hospital from January 2020 to March 2023 were selected. Among them,3 patients died during transit and 100 cases were finally included. They were divided into conventional group(n=48) and observation group(n=52) according to the first aid protocol. The conventional group received conventional emergency management and hybrid blood purification,while the observation group received standardized emergency management and hybrid blood purification. The treatment effects,emergency-related conditions[recovery time of consciousness,time of resolution of poisoning symptoms,dosage of atropine and penehyclidine hydrochloride,recovery time of cholinesterase(ChE),hospitalization time,ventilator use time],inflammatory indicators before and after intervention[tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),interleukin-8(IL-8)],complications,and emergency behavior ability were observed in both groups. Results The observation group had a better rate of good salvage results than the conventional group,and the difference was statistically significant(P<0.05). The observation group had shorter recovery time of consciousness,time of resolution of poisoning symptoms,recovery time of ChE,hospitalization time,and use time of ventilator than the conventional group,and the doses of atropine and penehyclidine hydrochloride used were lower than those in the conventional group,with statistically significant differences(P<0.05). At 48 hours after intervention,the levels of TNF-α, TGF-β1 and IL-8 in both groups were lower than those before intervention,and those in the observation group were lower than the conventional group,and the differences were statistically significant(P<0.05). The complication rate of the observation group was 11.5％(6/52),which was lower than that of the conventional group[33.3％(16/48)],and the difference was statistically significant(P<0.05).The observation group's speed of attendance,ability to cooperate in rescue care,emergency response ability,preparation of emergency supplies,rescue ability,and overall quality of care were all better than those of the conventional group,and the differences were all statistically significant(P<0.05). Con-clusion Standardized emergency treatment combined with hybrid blood purification can improve the treatment effect,enhance the ability of emergency behavior,shorten the treatment time,reduce the incidence of complications,and alleviate the inflammatory response.