早期血气分析对急性有机磷农药中毒患者预后的预测

Earlier blood gas analysis can predict the outcome of patients with acute organophosphate poisoning

目的探讨急性有机磷农药中毒(AOPP)患者的酸碱平衡与死亡率的关系。方法回顾性研究我院2000-01～2006-01在急诊科就诊并收入住院的78例连续的、中毒时间在24 h内的AOPP患者,依据第一次动脉血气结果判断是否存在酸中毒及酸中毒类型,并对各类型的死亡率进行比较。结果AOPP患者分为无酸中毒组、代谢性酸中毒组、呼吸性酸中毒组和混合型酸中毒组,组间死亡率比较差异有统计学意义(P<0.01)。有代谢性酸中毒的AOPP患者死亡率为22.5%,其中71.4%死于心力衰竭;有呼吸性酸中毒的AOPP患者死亡率为42.9%,其中66.7%死于呼吸衰竭。结论酸碱度能有效预测AOPP患者的死亡率,代谢性酸中毒组的死亡原因与呼吸性酸中毒组不同。

Objective To explore the relationship between acid -base equilibrium and the mortality in the patients with acute organophosphate poisoning （AOPP）. Methods 78 consecutive patients with AOPP were admitted to our hospital within 24 hours after the exposure to organophosphate from January 2000 to January 2006,and were retrospectively studied. Results Patients with AOPP were divided into 4 groups： without acidosis, metabolic acidosis, respiratory acidosis, and mixed acidosis. There were statistical significances in the mortality among the groups （P 〈0.01 ）. The mortality of AOPP patients with metabolic acidosis was 22.5%, and 71.4% of those patients died of heart failure. The mortality rate of AOPP with respiratory acidosis was 42.9%, and 66.7% of those patients died of respiratory failure. Conclusion Acid - base equilibrium can be effective in the prediction of the outcome of patients with AOPP. Major causes of death are different between the respiratory acidosis and metabolic acidosis groups.