留置胃管间断洗胃联合蒙脱石散在口服有机磷中毒抢救中的应用

Application of indwelling gastric tube for intermittent gastrolavage combined with Montmorillonite powder for salvage of organophosphorous poisioning

目的探讨留置胃管间断洗胃联合蒙脱石散胃管内注入在口服有机磷中毒抢救中的应用效果。方法选择在我院进行抢救的有机磷中毒的患者64例,随机分为研究组和对照组各32例。对照组给予常规治疗,研究组在此基础上采用留置胃管间断洗胃,并配合蒙托石散胃管内注入进行抢救治疗。观察比较两组的临床疗效。结果治疗后12、36、60、84 h研究组的胆碱酯酶活性均明显高于对照组(P<0.01)。研究组阿托品化时间显著短于对照组,ChE恢复到正常的50%时间显著短于对照组,差异有统计学意义(P<0.01)。研究组反跳的比例显著低于对照组,差异有统计学意义(P<0.05)。两组并发症总的发生率比较差异有统计学意义(P<0.05)。结论留置胃管间断洗胃联合蒙脱石散胃管内注入用于抢救口服有机磷中毒,可以减少反跳发生率,缩短阿托品化时间和住院时间,减少并发症的发生率,快速恢复胆碱酯酶活性。

Objective To discuss application efficacy of indwelling gastric tube for intermittent gastrolavage combined with Montmorillonite powder for salvage of organophosphorous poisioning. Methods Selected 64 cases with organophosphorous poisioning salvaged in our hospital were divided into study group and control group （each group with 32 cases）. Control group was treated with normal treatment. Bases on this, study group was indweh gastric tube for intermittent gastrolavage, combined with Montmorillonite powder injected into stomach by gastric tube. Clinical ef- ficacy of two groups was compared. Results Cholinesterase activity of study group at 12, 36, 60, 84 h after treatment were higher than control group （P 〈 0.01）. Dosage of Atropine and cholinesterase reactivator were less than control group, atropinization time and ChE return to the 50% normal of the time were shorter than the control group （P 〈 0.01）. Rebound proportion of study group was lower than the control group （P 〈 0.01）. The total of incidence of complications had significant difference between two groups （P 〈 0.05）. Conclusion Indwelling gastric tube for intermittent gas- trolavage combined with Montmorillonite powder for salvage of organophosphorous poisioning can reduce rebound in- cidence and complications, reduce Atropine and cholinesterase reactivator dosage, shorten atropinization time and hos- pital stays, and promote reply cholinesterase activity.