持续胃肠道低负压引流对口服有机磷中毒救治效果的影响

Effectiveness of Persistent Negative Pressure Suction in Treating Severe Organophosphorus Pesticides Poisoning

目的探讨持续胃肠道低负压引流在抢救经口服急性有机磷农药中毒（AOPP）中的效果。方法将36例AOPP患者随机分成两组。对照组（19例）采用传统洗胃、导泻法；研究组（17例）于常规洗胃、导泻后，行胃肠道间断（4～6h 1次）甘露醇或生理盐水灌洗加持续胃管及肛管低负压吸引。比较两组阿托品及解磷定用量、胆碱酯酶上升至正常50％时间、昏迷时间及腹胀便秘、反跳、中间综合征发生率。结果研究组阿托品及解磷定用量显著少于对照组（均P〈0．05），胆碱酯酶上升时间、患者昏迷时间显著短于对照组（均P〈0．05）。结论持续胃肠道低负压吸引能有效清除AOPP患者胃肠道毒物，有利于患者恢复。

Objective To investigate the effectiveness of persistent negative pressure suction in treating acute organophosphorus pesticides poisoning （AOPP）. Methods Thirty six AOPP patients were randomly divided into two groups. In 19 cases of control group, the patients were subjected to conventional gastric lavage and catharsis. In 17 cases of experimental group, the patients were treated with discontinuous saline lavage （every 4-6 h） and persistent negative pressure suction following conventional gastric lavage and catharsis. The dosage of atropine and pralidoxine iodide, the ascending speed of CHE, the duration of coma and the incidence of intermediate syndrome between the two groups were compared. Results The dosage of atropine and pralidoxine iodide in the experimental group was obviously less （all P〈 0.05）, and CHE ascending time and the duration of coma was obviously shorter in experimental group than those in control group （all P〈0.05）. Conclusion The method of persistent negative pressure suction can cleanse the gastrointestinal poison in the AOPP patients timely and efficiently, obviously increase the curative effectiveness and decrease the complication of AOPP patients.