尽早呼吸支持技术对中重度急性有机磷农药中毒患者预后的影响

Effect of early respiratory support technology on the prognosis of patients with severe acute pesticide poisoning

目的探讨尽早呼吸支持技术对中重度急性有机磷农药中毒患者预后的影响。方法治疗组选择2008年10月至2009年10月符合急性有机磷农药中毒患者36例在常规治疗基础上预防性开放气道、适当放宽呼吸机使用指征尽早机械通气。对照组为2007年10月至2008年10月符合中重度急性有机磷农药中毒患者40例,在常规治疗基础上,只有当患者发生呼吸衰竭或呼吸、心搏骤停才开放气道、机械通气。结果与对照组比较,治疗组急性呼吸窘迫综合征、吸入性肺炎、阿托品中毒等并发症明显减少(P<0.05),病死率显著降低(P<0.010、住院天数缩短(P<0.05)。结论在中重度急性有机磷农药中毒救治中,预防性气道开放、适当放宽呼吸机使用指征尽早机械通气能改善患者预后,降低病死率,缩短住院天数,值得推广。

Objective To explore the effect of early respiratory support technology on the prognosis of patients with severe acute organic pesticide poisoning（AOPP）.Methods The treatment group,36 cases with AOPP selected from October 2008 to October 2009 treated with the basis of conventional therapy and preventive open airway with adequate breathing machine.The indications of mechanical ventilation used to relax as soon as possible.The control group were analyzed retrospectively from October 2007 to October 2008,40 patients with AOPP were treated only with the basis of conventional therapy,the indications of open airway and mechanical ventilation were only the patients with respiratory failure or respiratory,cardiac arrest.Results Compared with control group,not only the complications such as ARDS,aspiration pneumonia,atropine poisoning significantly reduced（P0.05）,but the mortality also significantly decreased（P0.01）,shorter as well were the hospitalization days（P0.05）.Conclusion Treatment of severe AOPP with preventive airway open and use the appropriate indications for mechanical ventilation as soon as possible can improve the prognosis of patients with lower mortality and shorter hospital stay days and worth promoting.