论文部分内容阅读
目的分析急性有机磷农药中毒致呼吸衰竭的相关危险因素,制定急救措施。方法选取2014年1月—2016年1月在井冈山大学附属医院急救的急性有机磷农药中毒者45例,根据患者是否出现呼吸衰竭分为衰竭组25例和非衰竭组20例。比较两组患者的各项指标〔血糖、急性生理学及慢性健康状况评分量表(APACHEⅡ)评分、脏器损伤、胆碱酯酶、胃管洗胃以及阿托品总量〕,分析各项指标与急性有机磷农药中毒致呼吸衰竭的影响因素,并制定急救措施。结果呼吸衰竭时间0.5~96.0h;上机时间1~144h;形成原因:肺水肿、中间综合征以及解毒剂过量。相关分析结果显示,血糖与急性有机磷农药中毒致呼吸衰竭无相关性(r=0.027,P>0.05),APACHEⅡ评分、脏器损伤及阿托品总量等与急性有机磷农药中毒致呼吸衰竭呈正相关(r=0.462、0.599、0.346,P<0.05),胆碱酯酶与急性有机磷农药中毒致呼吸衰竭呈负相关(r=-0.380,P<0.05)。结论脏器损伤数量和胆碱酯酶含量可作为呼吸衰竭发生的参考指标,留置胃管洗胃和正确使用阿托品是防治呼吸衰竭的重要手段。
Objective To analyze the related risk factors of respiratory failure caused by acute organophosphorus pesticide poisoning and make emergency measures. Methods Forty-five acute organophosphorus pesticide poisoning patients from January 2014 to January 2016 in Jinggangshan University Hospital were divided into two groups according to whether patients had respiratory failure or not: 25 patients in failure group and 20 patients in non-exhaustion group. The indicators of the two groups were compared (APACHEⅡ, APACHEⅡ, organ injury, cholinesterase, gastric lavage and total atropine) Factors Affecting Respiratory Failure Caused by Organophosphorus Pesticide Poisoning and Formulate First-aid Measures. Respiratory failure time 0.5 ~ 96.0h; on the machine time 1 ~ 144h; Causes: pulmonary edema, intermediate syndrome and antidote overdose. Correlation analysis showed that there was no correlation between blood glucose and respiratory failure caused by acute organophosphorus pesticide poisoning (r = 0.027, P> 0.05), APACHEⅡscore, organ damage and total atropine were positively correlated with respiratory failure caused by acute organophosphorus pesticide poisoning (r = 0.462,0.599,0.346, P <0.05). Cholinesterase was negatively correlated with respiratory failure caused by acute organophosphorus pesticide poisoning (r = -0.380, P <0.05). Conclusion The number of organ injury and cholinesterase levels can be used as a reference index for respiratory failure. Indwelling gastric tube gastric lavage and correct use of atropine are important means of prevention and treatment of respiratory failure.