活性炭吸附联合导泻救治急性有机磷中毒的疗效研究

Study of curative effect about adsorption of activated charcoal and purgation in rescue of organophosphate poisoning

目的:探讨活性炭吸附联合导泻对急性有机磷中毒的临床疗效。方法:选择50例重度急性有机磷中毒患者随机分为两组各25例。对照组采用传统治疗方法;实验组采用传统治疗方法加活性炭悬液胃肠道反复灌洗,灌洗后导泻。观察两组患者服毒至开始抢救时间、入院时胆碱酯酶活力、反跳发生病例数、呼吸衰竭发生病例数、中间综合征(IMS)发生病例数、死亡病例数;观察两组中存活病例达阿托品化的时间、达阿托品化所需的阿托品用量、入院至痊愈阿托品用药总量及住院时间。结果:实验组达阿托品化所需的时间及住院时间均短,差别有高度显著性意义(P<0.01);反跳发生病例数少,达阿托品化所需的阿托品量及入院至痊愈阿托品用药总量也较对照组少,差别有显著性意义(P<0.05)。结论:活性炭吸附联合导泻可明显缩短急性有机磷中毒患者达阿托品化的时间,减少阿托品用量,降低反跳的发生率并显著缩短住院时间。

Objective：To study the curative effect about adsorption of activated charcoal and purgation in the rescue of organophosphate poisoning. Methods ：50 seriously patients of organophosphate poisoning were divided into two groups, each group has 25 patients. The patients in control group were treated in traditional way, and the patients in experimental group were treated by lavaging gastrointestinal tract repeatedly using activated charcoal and catharsising after lavaging, as well as in traditional way. The cholinesterase energy in hospitalization, the number of patients which had a relapse course, the cases of respiratory failure and the cases of intermediate syndrome and the cases of death were observed after taking poison. The period and atropine dose before atropinization,the total amount of atropine and the length of stay were also been observed. Resuits ： The time before atropinization and the length of stay in experimental group were shorter than in comparable group, the differences were very significant（ P 〈 0. 05 ）. And there are also a significant difference in the number of patients which had a relapse course, atropine dose before atropinization, the total amount of atropine（ P 〈 0. 05 ）. Conclusion： The methods of lavaging gastrointestinal tract repeatedly using activated charcoal and catharsising after lavaging could shorten the time before atropinization, reduce the dose of atropine, cut down the incidence rate of relapse and shorten the length of stay.