集束化和环节质量控制策略在急性重度有机磷中毒治疗中的应用

Application of Cluster and Link Quality Control Strategies for the Treatment of Acute Severe Organophosphorus Poisoning

目的:观察集束化和环节质量控制策略对急性重度有机磷中毒(ASOPP)治疗效果的影响。方法:以2010年7月～2012年6月在我科诊治的ASOPP患者19例为治疗组,采用器官支持、彻底清除毒物、早期足量反复应用复能剂及抗胆碱能药物等集束化治疗,同时对各个治疗环节进行质量控制及反馈:以2008年7月～2010年6月按常规诊治的ASOPP患者23例为对照组:比较两组重症监护时间、昏迷后清醒时间、阿托品化时间、阿托品用量、发生反跳或中间综合征的例数、胆碱酯酶(ChE)恢复正常时间、住院天数、住院费用的差异。结果:与对照组相比,治疗组阿托品化时间、阿托品用量明显减少(P<0.01):重症监护时间、昏迷后清醒时间、发生反跳或中间综合征的例数、ChE恢复正常时间、住院天数、住院费用明显降低(P<0.05)。结论:集束化和环节质量控制策略应用于ASOPP的治疗,可提高抢救成功率,减少并发症。

Objective： To observe the effect of cluster and link quality control strategy for acute severe organophosphorus poisoning （ASOPP） treatment effect. Methods： 19 patients with ASOPP from Jul 2010 to Jun 2012 were selected as the treatment group, the organ support, elimination of toxins, early enough repeated application of complex agent and antieholinergic drug such as bundle treatment, for each treatment link quality control and feedback. 23 cases given routine treatment were selected as control group from Jul 2008 to Jun 2010. The distinction in time of atropinization, dosage of atropine, intensive care, coma. to awake, bounce or intermediate syndrome, ChE＇ s recovery, the hospital days and the cost of hospitalization were compared between the two groups. Result： Compared with the control group, cluster and link quality control strategy obviously decreased the time of atropinization, dosage of atropine （P 〈 0.01 ）, intensive care,coma to awake, bounce or intermediate syndrome, CHE＇s recovery ,hospital days and the cost of hospitalization（P 〈 0.05）. Conclusion： The cluster and link quality control strategy have beneficial effects for treatment of ASOPP.