气管插管胃镜明视下洗胃在急性重度有机磷农药中毒中的效果观察

Effect of gastric lavage under tracheal intubation and direct vision endoscopy in acute severe organophosphorus pesticide poisoning

目的探讨气管插管胃镜明视下洗胃在急性重度有机磷农药中毒的临床作用。方法急性重度有机磷农药中毒患者80例,随机分为气管插管胃镜明视下洗胃组(试验组)及常规洗胃组(对照组),每组40例,比较两组胃管插管一次性成功率、洗胃时间、洗胃液量、消化道出血、液体自口鼻喷出、中断洗胃率、阿托品化出现时间、住院时间、中间肌无力综合佂(IMS)和抢救成功率。结果气管插管胃镜明视下洗胃组及常规洗胃组比较:胃管插管一次性成功率提高(P<0.01)、洗胃时间缩短(P<0.01)、洗胃液量减少(P<0.01)。消化道出血、液体自口鼻喷出、中断洗胃例数三项并发症明显减少(P<0.01)。阿托品化时间缩短(P<0.01)、住院时间减少(P<0.01)、中间肌无力综合佂(IMS)发生率降低(P<0.01)、抢救成功率提高(P<0.05),两组比较差异有统计学意义。结论气管插管胃镜明视下洗胃用于抢救急性重度有机磷农药中毒能明显地提高疗效。

Objective To observe the effect of gastric lavage under tracheal intubation and direct vision endoscopy in acute severe organophosphorus pesticide poisoning.Methods 80 patients of acute severe organophosphorus pesticide poisoning were randomly divided into two groups：group of gastric lavage under tracheal intubation and direct vision endoscopy（test group） and group of conventional gastric lavage（control group）.Two groups were compared with one-time success rate of stomach intubation,gastric lavage time,washing volume of gastric juice,gastrointestinal bleeding,the liquid ejected from nose and mouth,interrupted rate of gastric lavage,time of atropinization,time of hospitalization,rate of intermediate myasthenia syndrome（IMS）,and the survival rate.Results There were significant difference between two groups：The test group had a higher one-time stomach intubation success rate than that of the control group（P〈0.01）,and the time of gastric lavage was shortened（P〈0.01）,washing volume of gastric juice was decreased（P〈0.01）,the three complications of gastrointestinal bleeding,the liquid ejected from mouth and nose and the interrupted rate of gastric lavage were reduced（P〈0.01）.And the time of atropinization was reduced（P〈0.01）,the time of hospitalization was decreased（P〈0.01）,rate of intermediate myasthenia syndrome（IMS） was reduced（P〈0.01）,and the survival rate was increased（P〈0.05）.Conclusion Gastric lavage under tracheal intubation and direct vision endoscopy could significantly improve the effect of treatment in acute severe organophosphorus pesticide poisoning.