经皮穴位电刺激足三里在有机磷农药中毒患者抢救中的应用

Transcutaneous Electrical Stimulation Undergoing Emergency Treatment of Zusanli(ST 36)Is Beneficial to Rescued Organophosphorus Pesticide Poisoning Patients

目的:探讨经皮穴位电刺激足三里对有机磷农药中毒患者胃肠道毒物的清除作用。方法:口服有机磷农药中毒患者116例分为电刺激组和对照组各58例,两组患者均按照有机磷农药中毒诊疗规范给予综合治疗,电刺激组在首次彻底洗胃后胃管内注入甘露醇导泻和药用炭片吸附毒物前,配合应用经皮穴位电刺激双侧足三里穴,对照组仅常规应用导泻剂和吸附剂。观察两组患者首次彻底洗胃后胃管内注入导泻剂所致的呕吐发生率,应用导泻剂后首次大便时间和排出黑便时间,患者阿托品使用总量,患者住院时间。结果:对照组呕吐发生率明显高于电刺激组(P<0.05),电刺激组首次排便时间和首次排出黑便时间较对照组明显缩短(P<0.05);两组患者住院期间阿托品使用总量比较,电刺激组明显少于对照组(P<0.05);电刺激组住院时间明显少于对照组(P<0.05)。结论:口服有机磷农药中毒的患者配合经皮穴位电刺激足三里穴治疗,可降低呕吐发生率,增强导泻效果,促使胃肠道内毒物尽快排出,减少住院期间阿托品使用总量,缩短患者住院时间,提高临床抢救效果。

Objective To observe the effect of transcutaneous acupoint electrical stimulation（TAES）of Zusanli（ST 36）on gastrointestinal activities in organophosphorus pesticide poisoning（OPP）patients undergoing emergency treatment so as to explore its action in scavenging gastrointestinal toxicant.Methods A total of 116 OPP patients were randomly divided into control group and TAES group（n=58in each group）according to the simple random sampling method.All the patients received comprehensive treatment including gastric lavage,catharsis,oral administration of atropine Pralidoxime Chloride,Omeprazole,etc.For patients of the TAES group,TAES stimulation（30Hz/60 Hz,15-20mA）was applied to bilateral Zusanli（ST 36）for 30 min,3times a day till black stool was discharged.The vomiting times after catharsis,the time of the first defecation and black stool discharge,the dosage of atropine and the length of patient stay in hospital were recorded.Results Of the two 58 cases of OPP patients in the control and TAES groups,11（18.9%）and 3（5.2%）underwent vomiting after catharsis,being significantly lower in the TAES group（P〈0.05）.Compared with the control group,the time of first defecation and black stool discharge,the dosage of the administrated atropine and the time of hospitalization were significantly lower in the TAES group（P〈0.05）.Conclusion TAES of ST 36 may lower incidence of emesis,enhance the cathartic effect,promote gastrointestinal poison discharge,reduce total atropine dosage and shorten the hospitalization time in OPP patients,favoring the patient＇s rehabilitation.