早期鼻空肠管置管用于重症有机磷中毒30例分析

目的研究早期鼻空肠管置管在重症有机磷中毒的应用。方法选取医院急诊科收治的60例口服有机磷农药中毒重度患者，随机分为对照组与治疗组。两组患者均常规给予以洗胃（6h内）、洗胃前气管插管行气管保护、阿托品、胆碱能复能剂、补液、纳洛酮、必要时呼吸机辅助呼吸、血液灌流等常规处理。对照组在常规治疗基础上予留置胃管及20％甘露醇250mL导泻：治疗组在常规治疗基础上予早期鼻肠管置管及生大黄50g浸泡液50mL导泻。结果治疗组的抢救成功率高于对照组，但两组比较，无显著性差异（P〉0．05）；治疗组患者的早期肠内营养的时间、住院时间均明显短于对照组，且相关性肺炎发生率少于对照组（P〈0．05）。结论早期鼻肠管置管治疗重症有机磷农药中毒可缩短住院时间、早期肠内营养时间．减少相关性肺炎的发生率。

Objective Early nasojejunal tube application in severe organophosphorus poisoning.Methods Were selected in the emergency department of our hospital,a total of 60 cases of oral organophosphorus pesticide poisoning patients,wer randomly assigned to control group and treatment group,two groups of patients were routinely to be gastric lavage （within 6 hours）,gastric lavage before tracheal intubation tracheal protection,atropine,choline complex agents,rehydration,naloxone,when necessary,ventilator assisted breathing,blood perfusion of conventional treatment.Control group in the conventional treatment on the trealed with indwelling gastric tube and 20% mannitol 250 mL catharsis;treatment group in conventional treatment given early nasointcstinal tube catheterization and rhubarb 50 grams of soaking solution 50 mL catharsis.Observe the two groups of patients with early enteral nutrition of the time,length of hospital stay,the incidence of pneumonia （pneumonia,ventilator associated pneumonia）,the success rate of rescue.Results The success rate of the treatment group was higher than that of the control group,but there was no significant difference between the two groups （P〉 0.05）;the time and length of hospital stay in patients with early enteral nutrition were significantly shorter than those in control group and the correlation with pneumonia were less than those in control group,and the difference was statistically significant （P 〈 0.05）.Conclusion Early nasointestinal tube indwelling tube shorten hospitalization time,time of early enteral nutrition and reduce associated pneumonia incidence of treatment of acute severe organophosphorus pesticide poisoning.