血液灌流与常规治疗对急性有机磷农药中毒胆碱酯酶恢复时间及死亡率的Meta分析

Meta-Analysis of Recovery Time and Mortality of Cholinesterase in Acute Organophosphorus Pesticide Poisoning by Hemoperfusion and Routine Treatment

摘要: 目的：探讨血液灌流对比常规治疗对急性有机磷农药中毒(AOPP)的胆碱酯酶恢复时间及死亡率情况。方法：在PubMed、万方、维普、中国知网等数据库中检索血液灌流治疗急性有机磷农药中毒的相关文献，检索时间为2015年4月1日至2025年11月15日。根据纳入与排除标准筛选文献，提取主要结局指标数据。应用Review Manager 5.4软件进行Meta分析。结果：共纳入7项研究，642例患者，其中血液灌流组321例，常规治疗组321例。Meta分析结果显示，与常规治疗组相比，血液灌流组患者死亡率(OR = 0.24, 95% CI: 0.14~0.41, P < 0.00001)和胆碱酯酶恢复时间(MD = −3.07, 95% CI: −3.34~−2.80 d, P < 0.00001)显著降低。结论：血液灌流治疗AOPP非常安全，能有效提高患者存活率，降低死亡率，缩短胆碱酯酶恢复时间。

Abstract: Objective: To investigate the effects of hemoperfusion versus routine treatment on cholinesterase recovery time and mortality of acute organophosphorus pesticide poisoning (AOPP). Methods: The related literature of hemoperfusion in the treatment of acute organophosphorus pesticide poisoning was searched in PubMed, Wanfang, VIP, and China National Knowledge Infrastructure from April 1, 2015 to November 15, 2025. The literature was screened according to the inclusion and exclusion criteria, and the main outcome index data were extracted. Meta-analysis was performed using Review Manager 5.4 software. Results: A total of 7 studies involving 642 patients were included, including 321 in the hemoperfusion group and 321 in the conventional treatment group. The results of Meta-analysis showed that compared with the conventional treatment group, the mortality rate (OR = 0.24, 95% CI: 0.14~0.41, P < 0.00001) and cholinesterase recovery time (MD = −3.07, 95% CI: −3.34~−2.80 d, P < 0.00001) in the hemoperfusion group were significantly lower. Conclusion: Hemoperfusion is very safe in the treatment of AOPP. It can not only effectively improve the survival rate of patients, reduce the mortality rate, but also shorten the recovery time of cholinesterase.