口服有机磷农药重度中毒患者开始进食时间的研究

A study about the proper time of intake food for patients with moderate and severe organophosphorus poisoning

目的探讨口服有机磷农药重度中毒患者适宜的进食时间。方法随机将119例口服有机磷农药重度中毒患者分为3组。在综合抢救治疗的基础上，A组（40例）于中毒后12～24h开始进食，B组（38例）于中毒后24～48h开始进食，C组（41例）于中毒48h后开始进食，观察比较不同开始进食时间对患者病情的影响。结果3组患者中间期肌无力综合征（IMS）。中毒反跳发生率的差异均无显著性（P〉0．05）；电解质紊乱、院内感染、多脏器功能障碍综合征（MODS）的发生率，B、C组显著高于A组（P〈0．05）；平均应用呼吸机时间、平均气管插管时间、ICU平均监护日，A组显著短于B、C组（P〈0．05）；患者死亡率A、B2组差异无显著性（P〉0．05），C组显著高于A组（P〈0．05）。结论口服有机磷农药重度中毒患者，在反复彻底洗胃，无胃出血、胰腺炎等并发症、足量应用阿托品和复能剂的前提下，于中毒后12-24h进食，可减少水电质酸碱平衡紊乱、院内感染、MODS等并发症的发生，缩短气管插管时间和呼吸机应用时间。缩短监护天数，提高抢救成功率。

Objectve To study the proper time of intake food for patients with moderate and severe organophosphorus poisoning. Methods Divided 119 organophosphorus poisoning patients into 3 groups randomly, given expectant - combined treatment to all the patients. Group A （40 cases）, began intake food in 1224 hours after poisoning. Group B （38 cases） , began intake food in 2448 hours after poisoning. Group C （41 cases）, began intake food in 48 hours after poisoning, then observe the difference of patient!s condition in thee 3 groups. Results There were no significant differences about the incidence rate of IMS.and poisoning rebound in these 3 groups, P〉0.05. The incidence rate of electrolyte disturbance, infection in hospital and MODS in group B and C were significant higher than tbese of in group A, P〈0.05, while the time of using respirator, tracheal tube and the days of using ICU monitor in group B.a.nd C were significant longer than those of in group A, P〈0.05. There were no significant difference between group A and B about the mortality of patients, P 〉0.05. The mortality V of patients in group C was significant higher than that of in group A, P〈0.05. Conclusion It can effective lower the incidence rate of electrolyte disturbance, infection in hospital and the MODS when intake food within 12-24 hours after poisoning for patients with moderate and severe organophosphorus poisoning, which can also lower the time of using respirator, tracheal tube and the days of using ICU monitor, and then increase the rescue rate. but the me to begin diet for patients with severe oral organophosphorus pesticides poiso.