32例有机磷农药中毒院前催吐洗胃可行性和效果分析

Analysis of feasibility and effect of prehospital emetic and gastric lavage in 32 cases with organophosphorus pesticide poisoning

目的 探讨急性有机磷农药中毒（AOPP）院前催吐洗胃的可行性和效果分析。方法 回顾性分析2010年1月-2016年1月32例院前接受催吐洗胃患者的阿托品、氯解磷定用量以及中间综合征（intermediate syndrome,IMS）发生率和死亡率,与48例院内接受催吐洗胃者进行比较。结果 在院前接受洗胃的患者洗胃开始时间明显早于院内洗胃组,在相对较少的洗胃量情况下取得满意效果。阿托品和氯解磷定用药量、中间综合征发生率和死亡率均低于院内洗胃组（P〈0.05）。结论 尽早洗胃是抢救有机磷中毒的最有效措施,院前催吐洗胃具有可行性、有效性。

Objective To discuss and study the feasibility and efficacy of prehospital emetic and gastric lavage due to acute organophosphorus pesticide poisoning（AOPP）. Methods The dosage of atropine and chlorphenamine and the inci- dence and mortality of intermediate syndrome（IMS） in 32 patients who were given prehospital emetic and gastric lavage from January 2010 to January 2016 were retrospectively analyzed. They were compared with 48 patients who were given in-hospital emetic and gastric lavage. Results The gastric lavage start time in patients receiving pre-hospital gastric lavage was significantly earlier than that in in-hospital gastric lavage group. Satisfactory results were obtained under relatively low gastric lavage volume. Atropine and pralidoxime chloride dosage, incidence and mortality of intermediate syndrome were lower than those in in-hospital gastric lavage group（P〈0.05）. Conclusion Earlier gastric lavage is the most effective measure to rescue organophosphate poisoning, which is feasible and effective in pre-hospital emetic and gastric lavage.