急性有机磷农药中毒并呼吸衰竭急诊抢救的效果探讨

Investigateing the Effect of Acute Organophosphorus Pesticide Poisoningon Emergency Treatment of Respiratory Failure

目的:研究急性有机磷农药中毒(AOPP)并呼吸衰竭急诊抢救的效果。方法:将新乡医学院第一附属医院2015年5月至2016年10月AOPP并呼吸衰竭患者88例随机分两组。抢救组A采用常规抗胆碱能药物治疗,维持呼吸道通畅,导泻等治疗,抢救组B在抢救组A基础上增加血液灌流和机械通气治疗。比较两组患者急性AOPP并呼吸衰竭治愈率;胆碱酯酶活力恢复时间、昏迷持续时间、呼吸衰竭缓解时间、阿托品使用剂量;治疗前和治疗后患者胆碱酯酶水平的差异。结果:抢救组B患者急性AOPP并呼吸衰竭治愈率高于抢救组A(P<0.05);抢救组B胆碱酯酶活力恢复时间、昏迷持续时间、呼吸衰竭缓解时间显著短于抢救组A,阿托品使用剂量低于抢救组A(P<0.05);治疗前两组胆碱酯酶水平比较,差异无统计学意义(P>0.05);治疗后两组胆碱酯酶水平均显著改善,但抢救组B改善幅度更大(P<0.05)。结论:AOPP并呼吸衰竭急诊抢救的效果确切,可有效改善患者预后,促进胆碱酯酶水平恢复正常,缩短昏迷时间,减少阿托品使用量。

Objective To study the effect of emergency treatment of acute organophosphorus pesticide poisoning（AOPP） and respiratory failure. Methods 88 patients with AOPP and respiratory failure in the first Affiliated Hospital of Xinxiang Medical College from May 2015 to October 2016 in were randomly divided into two groups. Rescue group A treatment with conventional anticholinergic drugs to maintain airway patency, catharsis and other treatment, rescue group B in the rescue group A on the basis of increased blood perfusion therapy and mechanical ventilation treatment. The recovery rate of cholinesterase activity, the duration of dysentery, the time of relieving heart failure, the dose of atropine, and the difference in cholinesterase levels before and after treatment were compared between the two groups. Results The cure rate of acute AOPP and respiratory failure in rescue group B was higher than that in rescue group A（P〈 0.05）. Resuscitation group B cholinesterase activity recovery time, halo duration, respiratory failure remission time was significantly shorter than the rescue group A, the dose of atropine was lower than that of rescue group A（P〉 0.05）. There was no significant difference in cholinesterase level between the two groups before treatment（P 〉0.05）. After treatment, the levels of cholinesterase were significantly improved, but the improvement rate of rescue group B was greater（P〈0.05）. Conclusion The acute organophosphorus pesticide poisoning（AOPP） and respiratory failure emergency rescue effect is accurate, can effectively improve the prognosis of patients, promote cholinesterase levels returned to normal, shorten the halo time, reduce the use of atropine.