重度急性有机磷农药中毒合并急性呼吸衰竭急诊治疗的临床分析

Clinical analysis of emergency treatment in acute serious organophosphate poisoning patients with acute respiratory failure

目的分析重度急性有机磷农药中毒(ASOPP)合并急性呼吸衰竭的急诊治疗。方法采用随机数字法将2018年1月~2018年6月收治的重度急性有机磷农药中毒合并急性呼吸衰竭患者86例分为L组和C组,每组43例。C组给予常规治疗,L组给予有创-无创序贯机械通气急诊治疗,观察L组与C组药品使用剂量、药品使用时间、住院时间以及临床疗效。结果 L组治疗后阿托品化时间、住院时间、阿托品用量均低于C组,差异有统计学意义(P <0.05);L组临床总治疗有效率97.12%明显高于C组83.72%,差异有统计学意义(P <0.05);L组并发症发生率为2.33%,与C组并发症发生率(9.30%)比较,差异有统计学意义(P <0.05)。结论创-无创序贯机械通气急诊治疗ASOPP合并呼吸衰竭可缩短阿托品化时间和住院时间,降低阿托品药物剂量,提高临床治疗安全性。

Objective To analyze the emergency treatment in acute serious organophosphate poisoning(ASOPP) patients with acute respiratory failure. Methods 86 ASOPP patients with acute respiratory failure(2018.01 ~ 2018.06) were randomly assigned to group L and group C, 43 cases in each group. Group C took the routine treatment;group L took invasive-noninvasive sequential mechanical ventilation. Drug dosage and medication time, hospitalization time were appraised. Results Compared with group C, medication time and dosage of Atropine, and hospitalization time in group L were substantially reduced(P < 0.05);the total effective rate in group L(97.12%) was significantly higher than group C(83.72%)(P < 0.05);complication rate in group L(2.33%) was significantly lower than group C(9.30%)(P < 0.05). Conclusion The invasive-noninvasive sequential mechanical ventilation can reduce the medication time and dosage of Atropine, hospitalization time, and increase the treatment safety.