急性重度有机磷农药中毒患者死亡危险因素分析

Analysis on risk factors of mortality in patients with acute severe organophosphorus pesticide poisoning

目的探讨急性重度有机磷农药中毒死亡的危险因素。方法回顾性分析急性重度有机磷农药中毒44例患者的临床资料,对各项危险因素进行统计分析,比较患者的病死率。结果 44例急性重度有机磷农药中毒患者住院期间病死率22.7%(10/44),其中急性生理学及慢性健康状况评分(APACHE)≥20分和<20分、年龄≥60岁和<60岁、合并低血压和未合并低血压、合并低氧血症和未合并低氧血症、合并代谢性酸中毒和未合并代谢性酸中毒的患者病死率比较,差异均有统计学意义(P<0.05或<0.01)。结论 APACHEⅡ分值、高龄、低血压、低氧血症、代谢性酸中毒可能是急性重度有机磷农药中毒患者死亡的危险因素,在临床中可以用于评估患者病情严重程度与死亡风险。

Objective To explore the risk factors of mortality in patients with acute severe organophosphorus pesticide poisoning. Methods Forty-four patients with acute severe organophosphorus pesticide poison were retrospectively analyzed.Various risk factors were statistically evaluated and mortality of patients was compared between groups.Results Hospital mortality in 44 patients with acute severe organophosphorus pesticide poisoning was 22.7%.The mortality was significantly different between APACHE Ⅱ score ≥20 group and APACHE Ⅱ score〈20 group （P 〈0.01）,between age ≥ 60 group and age〈 60 group （P 〈0.01）,between hypotensive group and non-hypotensive group （P 〈 0.05 ）,between hypoxemia group and non-hypoxemia group （P 〈 0.05 ）,between metabolic acidosis group and non-metabolic acidosis group （P 〈 0.05 ）.Conclusion APACHE Ⅱ score,age, hypotension, hypoxemia, metabolic acidosis may be the risk factors of mortality in patients with acute organophosphorus pesticide poisoning,and the items can be used to assess the severity of disease and mortality risk in clinic.