Rescue and late nursing of patients with acute poisoning of chlorpyrifos

Objective To explore the rescue and late nursing method of patients with acute poisoning of chlorpyrifos.Methods During July 2011 to July 2014, 42 cases of patients with acute poisoning of chlorpyrifos were selected as the object of study, all the patients were randomly divided into two groups: the observation group(21 cases) and control group(21 cases). The control group was given routine treatment, the observation group was given early hemoperfusion treatment on the basis of the control group. Two groups of patient's index including improvement time for consciousness disturbance, hospitalization time, total dosage of Atropine, total dosage of Pralidoxime Chloride in 72 h; cure rate,bounce rate, poisoning rate of atropine; activity changes of blood urea nitrogen(BUN), urinary creatinine(Cr), aspartate aminotransferase(AST), alanine aminotransferase(ALT), lactate dehydrogenase(LDH), creatine kinase(CPK), creatine kinase isoenzyme(CK-MB), and serum cholinesterase in 7 days of treatment were observed and compared. Results The improvement time for consciousness obstacle and the hospitalization time in the observation group [(5.6±1.3) h,(13.2±4.1) d]were significantly shorter than those of the control group [(7.9±2.6) h,(19.6±5.7) d], the total dosage of Atropine and the total dosage of Pralidoxime Chloride in 72 h in the observation group [(7.4±2.3),(22.7±7.2) mg] were significantly less than those of the control group [(18.4±5.3),(38.5±8.1) mg], the differences between the two groups were statistically significant(all P 0.01); the cure rate in the observation group(100.0%) was significantly higher than that of the control group(90.5%), the bounce rate, atropine poisoning rate in the observation group(14.3%, 4.8%) were significantly lower than those of the control group(33.3%, 28.6%), the differences between the two groups were statistically significant(all P 0.01); the level of BUN, Cr, AST, ALT, LDH, CP, KCK-MB in the observation group [(7.1±1.1) mmol/L,(112.9±8.4) μmol/L,(45.1±3.9) U/L,(45.1±5.3) U/L,(164.3±14.6) U/L,(167.4±5.6) U/L,(28.5±5.4) U/L] after treatment were significantly lower than those of the control group [(13.2 ±3.3) mmol/L,(148.3 ±11.2) μmol/L,(89.4 ±7.3) U/L,(78.3 ±6.3) U/L,(204.2 ±17.9) U/L,(181.3±7.8) U/L,(39.4±6.1) U/L], the differences between the two groups were statistically significant(all P 0.05); the changes of cholinesterase activity after 1, 3, 5, 7 d of treatment in the observation group [(214.3 ±21.3),(296.8±54.1),(482.1±71.3),(649.7±131.2) U/L] were higher than those of the control group [(303.1±27.5),(631.5±48.9),(913.7±89.2),(1573.4±157.4) U/L], the differences in each period between the two groups were statistically significant(all P 0.01). Conclusion Early hemoperfusion can accelerate the resurrection speed of cholinesterase in patients with acute poisoning of chlorpyrifos, and protect the function of main organs in the body, reduce the amount of antidote. It is worthy of clinical promotion.