急诊早期应用呼吸机抢救急性重症有机磷农药中毒致呼吸衰竭的临床效果

Clinical effect of early use of ventilator in emergency department in rescuing respiratory failure caused by acute severe organophosphorus pesticide poisoning

目的探讨急诊早期应用呼吸机抢救急性重症有机磷农药中毒致呼吸衰竭的临床效果。方法选取2016年9月~2019年8月在我院接受治疗的86例急性重症有机磷农药中毒致呼吸衰竭患者作为主要对象,运用数字随机表法分组,各43例。两组患者均实施常规抢救治疗,观察组在常规治疗基础上于早期用呼吸机抢救,对比两组患者的抢救成功率、自主呼吸恢复时间、意识恢复时间、住院时间以及治疗前后血气指标的变化情况。结果与对照组相比,观察组患者的抢救成功率更高,两组对比有显著差异;观察组患者的自主呼吸恢复时间、意识恢复时间、住院时间均显著短于对照组,两组的时间指标相比有显著差异(P<0.05);两组患者治疗前各项血气指标比较无显著差异,治疗后较治疗前均明显改善,且观察组的氧分压高于对照组,二氧化碳分压、pH值低于对照组,组间比较存在显著差异(P<0.05)。结论急诊早期应用呼吸机抢救急性重症有机磷农药中毒致呼吸衰竭的成功率更高,且患者的自主呼吸和意识恢复时间更短,血气指标有显著改善,总体治疗优势显著,可在临床上进一步推广和应用。

Objective To analyze the clinical effect of early use of ventilator in the emergency department in rescuing respiratory failure caused by acute severe organophosphorus pesticide poisoning.Methods Eighty-six patients with acute severe organophosphorus pesticide poisoning-induced respiratory failure who were treated in our hospital from September 2016 to August 2019 were selected as the main subjects.They were grouped by digital random table method,with 43 cases in each group.The patients in both groups were treated with conventional rescue treatment.The observation group was rescued by ventilator in the early stage on the basis of routine treatment.The rescue success rate,spontaneous breathing recovery time,consciousness recovery time,hospitalization time and blood gas index before and after treatment were compared between the two groups.Results Compared with that of the control group,the rescue success rate of the observation group was higher,and there was significant difference between the two groups.The spontaneous breathing recovery time,consciousness recovery time and hospitalization time of the observation group were significantly shorter than those of the control group,and there was a significant difference in time index between two groups(P<0.05).There was no significant difference in blood gas indexes between the two groups before treatment.The blood gas indexes after treatment were significantly improved compared with those before treatment.And the oxygen partial pressure of the observation group was higher than that of the control group.The partial pressure of carbon dioxide and pH were lower than those of the control group,and there was a significant difference between the groups(P<0.05).Conclusion The early use of ventilator in the emergency department to rescue acute severe organophosphorus pesticide poisoning has a higher success rate of respiratory failure,and the patient's spontaneous breathing and consciousness recovery time is shorter.The blood gas index is significantly improved,and the overall treatment advantage is significant.It can be clinically further promotion and application.