中西医结合治疗重症有机磷中毒的临床观察

Clinical Observation on Treating Severe Organophosphate Poisoning by Integrative Medicine

目的:观察气管插管下"改良绿豆甘草汤"洗胃结合常规方法治疗急性重症有机磷农药中毒的早期治疗效果。方法:将急性重症有机磷农药中毒患者87例随机分为综合治疗组、插管治疗组和常规治疗组,3组患者经过2小时治疗后观察各组2小时内阿托品的用量、治疗2小时后患者Pa O2、发生上消化道出血的例数、死亡例数。结果:2小时内阿托品的用量综合治疗组与其他2组相比明显减少(P<0.05);治疗2小时后Pa O2综合治疗组高于插管治疗组(P<0.05),插管治疗组高于常规治疗组(P<0.05);发生上消化道出血的例数综合治疗组明显少于其他2组(P<0.05);死亡率综合治疗组(0.00%)低于插管治疗组(3.45%),插管治疗组(3.45%)低于常规治疗组(10.24%)。结论:常规治疗结合气管插管下"改良绿豆甘草汤"洗胃治疗急性重症有机磷农药中毒可有效减少阿托品的早期用量,明显改善肺泡通气量,降低重症有机磷中毒病人早期死亡率。

Objective： To observe clinical effects of gastric lavage with modified LYuDou GanCao Tang com- bined with routine treatment under tracheal intubation in treating acute severe organophosphorus poisoning in early stage. Methods： Eighty-seven patients were randomly allocated to comprehensive treatment group, intubation treat- ment group and routine treatment group, the dosage of atropine within two hours, PaO~ of the patients, the cases suf- fering from upper gastrointestinal bleeding （UGB） and death cases were observed after three groups were treated in two hours. Results： The dosages of atropine decreased obviously within two hours when comprehensive treatment group was compared with the other two groups （P〈0.05）;after treating two hours, comprehensive treatment group was higher than intubation treatment group in PaO2（P〈0.05）, intubation treatment group was higher than routine treatment group （P〈0.05）; comprehensive treatment group was less than the other two groups in the cases with UGB （P〈0.05）;comprehensive treatment group （0.00%） was lower than intubation treatment group （3.45%） in mortality rate,intubation treatment group （3.45%） was lower than routine treatment group （10.24%）. Conclusion： Routine treatment combined with gastric lavage with modified LYuDou GanCao Tang under tracheal intubation could effectively reduce the dosages of atropine in treating acute severe organophosphorus poisoning at early stage, obviously improve alveolar ventilation and decrease early mortality rate of severe organophosphorus poisoning.