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目的 探讨口服农药中毒患者在洗胃前进行气管插管的应用价值.方法 收集2014年1月-2017年9月急送汉川市人民医院急诊科进行洗胃的78例口服农药中毒患者资料,所有中毒患者洗胃前均行心电监护、建立静脉通道,清除口鼻分泌物,有机磷中毒患者给予阿托品及解磷定等对症处理,然后根据急诊科气管插管新技术实施时间前后将78例患者分成两组,普通组为44例(全部为气管插管新技术实施时间前患者),插管组为34例(全部为气管插管新技术实施时间后患者).普通组在上述处理后直接进行洗胃,插管组在上述处理后先进行气管插管,然后再进行洗胃,观察对比两组患者洗胃效果.结果 两组患者胃管插入都能顺利通过,无明显差异.普通组患者在洗胃过程中患者心率为(138±20)次/min ,血压:(160±20)/(100±12)mmHg,呼吸:(28±5)次/min,血氧饱和度:(80±5)%,其中有15例患者在洗胃过程中突然出现呼吸、心跳骤停,停止洗胃后再进行气管插管、心肺复苏等抢救,5例抢救成功,10例抢救无效死亡,抢救成功率为33.33%;而插管组在洗胃过程中患者心率均在(94±18)次/min,血压为(124±16)/(74±12)mmHg,呼吸(20±4)次/min,血氧饱和度(95±3)%,其中有2例患者出现心跳、呼吸骤停,直接进行心肺复苏,全部抢救成功,抢救成功率为100%.结论 气管插管在口服农药中毒洗胃过程中能使患者生命体征保持平稳,血氧饱和度保持在正常范围内,可明显提高洗胃成功率和抢救率,减少死亡,值得临床推广.“,”Objective To explore the value of endotracheal intubation ahead of gastric lavage in treatment of oral pesticide poisoning. Methods 78 patients with oral pesticide poisoning, 28 males and 50 females, aged (51.5±7.8)(25~78), all undergoing ECG monitoring, establishment of venous channel,and antidote treatment, were randomly appointed into ordinary group (n＝44) undergoing gastric lavage directly after the measures above mentioned, and intubation group (n＝34) underging endotracheal intubation ahead of gastric lavage. Results Gastric tube insertion was successful in both groups. During the process of gastric lavage the heart rate of the ordinary group was (138±20) times/min, the blood pressure was (160±20/100±12)mmHg, the breath rate was (28±5)times/min, and the blood oxygen saturation was(80± 5)%. Cardiopulmonary arrest occurred suddenly during gastric lavage in 15 of the 44 patients. The process of gastric lavage was stopped immediately and cardiopulmonary resuscitation (CPR) was performed instead. The rescue achieved the goal in 5 cases with a success rate of 33.33%, and 10 cases died. During the process of gastric lavage the heart rate, blood pressure, breath rate, and blood oxygen saturation of the intubation group were (94±18)times/min, (124±16/84± 12)mmHg,(20±4)times/min, and (95±3)% respectively. Cardiopulmonary arrest occurred during gastric lavage in 6 of the 34 patients. The process of gastric lavage was ceased immediately and CPR was performed instead. The rescue succeded in 5 cases with a success rate of 83.33%, and one case died. Conclusion Helping keep the vital signs steady and keep the blood oxygen saturation remaining within the normal range, endotracheal intubation improves the success rate of gastric lavage and reduces the mortality in treatment of oral pesticide poisoning.