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目的探讨早期机械通气治疗重度有机磷农药中毒(ASOPP)合并呼吸衰竭的临床疗效。方法将86例重度ASOPP患者按数字表法随机分为观察组和对照组,每组43例,观察组患者在入院时立即行气管插管、呼吸机辅助呼吸,对照组患者在入院后出现呼吸节律不规则、呼吸表浅、呼吸困难或意识不清、呼吸停止时再给予气管插管、呼吸机辅助呼吸,两组患者均给予常规洗胃清除毒物和解毒治疗。观察两组患者的救治成功率、机械通气时间、住院时间、再插管率和肺部感染发生率。结果观察组治愈率为95.3%,明显高于对照组的81.4%(P﹤0.05);观察组患者机械通气时间、住院时间均较对照组明显缩短(P﹤0.01),再插管率和肺部感染发生率均较对照组显著降低(P﹤0.05)。结论 ASOPP合并呼吸衰竭患者早期给予机械通气治疗能有效地维持重要脏器的氧供给,避免呼吸衰竭由轻度发展到重度缺氧,为抗胆碱药和胆碱脂酶复能剂解毒等治疗提供时间保证,从而提高其救治的成功率,最大限度地降低其病死率。
Objective To investigate the clinical efficacy of early mechanical ventilation in the treatment of severe organophosphorus pesticide poisoning (ASOPP) combined with respiratory failure. Methods Eighty-six patients with severe ASOPP were randomly divided into observation group and control group according to the digital table method, with 43 patients in each group. The patients in the observation group were intubated immediately after admission and were ventilated with ventilator. The patients in the control group developed respiration after admission Irregular rhythm, shallow breathing, difficulty breathing or unconsciousness, respiratory arrest and then give tracheal intubation, ventilator-assisted breathing, both groups were given routine gastric lavage detoxification and detoxification treatment. The success rate of treatment, duration of mechanical ventilation, length of hospital stay, reintubation rate and incidence of pulmonary infection in both groups were observed. Results The cure rate in observation group was 95.3%, which was significantly higher than that in control group (81.4%, P <0.05). The mechanical ventilation time and hospital stay in observation group were significantly shorter than those in control group (P <0.01) Department of infection rates were significantly lower than the control group (P <0.05). Conclusions Early mechanical ventilation in ASOPP patients with respiratory failure can effectively maintain oxygen supply to vital organs and avoid respiratory failure from mild to severe hypoxia and provide time guarantee for anticholinergic and cholinesterase agents detoxification , Thereby increasing the success rate of its treatment, to minimize its mortality.