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目的探讨影响急性有机磷农药中毒患者预后的因素以及不同种类有机磷农药致死率的差异。方法回顾性分析急性有机磷农药中毒患者96例,对所有患者进行急性生理和慢性健康状况(APACHEⅡ)评分,统计血清胆碱酯酶活力、血液透析、血气分析等情况,对多种因素对患者预后的影响进行统计学分析,并评估不同有机磷农药中毒死亡率的差异。结果 96例患者中20例死亡,不同有机磷农药死亡率不同。APACHEⅡ评分与呼吸衰竭、患者死亡有关(OR值分别为1.194,1.273,P均<0.01)。马拉硫磷、辛硫磷、乐果、敌百虫死亡率为零,稻丰散为15.4%,甲胺磷为21.1%,氧化乐果为40.0%,甲拌磷为50%。血液透析对有机磷农药中毒预后无明显作用。结论 APACHEⅡ评分是判断急性有机磷农药中毒患者预后的有效指标,不同有机磷农药中毒死亡率不同。
Objective To explore the factors influencing the prognosis of patients with acute organophosphorus pesticide poisoning and the differences in the lethality of different kinds of organophosphorus pesticides. Methods A total of 96 patients with acute organophosphorus pesticide poisoning were retrospectively analyzed. The acute physiology and chronic health status (APACHEⅡ) score, serum cholinesterase activity, hemodialysis and blood gas analysis were analyzed in all patients. Prognosis of the impact of statistical analysis and assessment of different organophosphorus pesticide poisoning mortality differences. Results Of the 96 patients, 20 patients died and different organophosphate pesticide mortality rates were different. APACHE Ⅱ score and respiratory failure, the death of patients (OR = 1.194,1.273, P <0.01). Mortality for malathion, phoxim, dimethoate, and trichlorfon was zero with 15.4% for Ito-Phosphate, 21.1% for methamidophos, 40.0% for omethoate and 50% for phorate. Hemodialysis had no significant effect on the prognosis of organophosphate pesticide poisoning. Conclusion APACHE Ⅱ score is an effective indicator to judge the prognosis of patients with acute organophosphorus pesticide poisoning. Different organophosphorus pesticide poisoning mortality rates are different.