极重度有机磷农药中毒急救的探讨与临床分析

Discussion and clinical analysis of first aid for extremely severe organophosphorus pesticide poisoning

目的:探讨极重度有机磷农药中毒的急救措施和效果。方法:2017年7月-2019年7月收治极重度有机磷农药中毒患者52例,随机分为两组,各26例。两组均给予常规治疗;对照组给予间歇静脉注射阿托品治疗;研究组在间歇静脉注射阿托品基础上持续静脉滴注阿托品与血流灌注治疗。比较两组抢救效果、阿托品化用量及死亡率。结果:研究组死亡率低于对照组,阿托品化用量少于对照组,住院时间、阿托品化时间、肺水肿消失时间均短于对照组,差异均有统计学意义(P<0.05)。结论:选择持续静脉滴注与间歇静脉注射阿托品联合血流灌注疗法,对极重度有机磷农药中毒患者进行辅助治疗,能够有效提高抢救效果,促进病情恢复,减少阿托品用药量,降低死亡率。

Objective:To explore the first aid measures and effect of extremely severe organophosphorus pesticide poisoning.Methods:From July 2017 to July 2019,52 cases of extremely severe organophosphorus pesticide poisoning were enrolled,they were randomly divided into two groups with 26 cases in each group.Both groups were given conventional treatment.The control group was treated with intermittent intravenous atropine and the study group was treated with continuous intravenous atropine and blood perfusion on the basis of intermittent intravenous atropine.The rescue effect,the dosage of atropinization and mortality in the two groups were compared.Results:The mortality rate in the study group was lower than in the control group,the dosage of atropinization was lower than in the control group,the stays of hospitalization,the time of atropinization and the disappearance time of pulmonary edema were shorter than in the control group,the differences were statistically significant(P<0.05).Conclusion:The combination of continuous intravenous drip atropine and intermittent intravenous atropine with hemoperfusion therapy in the adjunctive treatment of patients with extremely severe organophosphorus pesticide poisoning,it can effectively improve the rescue effect,promote the recovery of the disease,reduce the dosage of atropine and reduce the mortality rate.