急诊呼吸机对重症有机磷农药中毒致呼吸衰竭患者血气分析指标的影响

Influence of emergency ventilator on blood gas analysis index in patients with respiratory failure caused by severe organophosphorus pesticide poisoning

目的探讨急诊呼吸机对重症有机磷农药中毒致呼吸衰竭患者血气分析指标的影响。方法选取2014年10月至2019年11月沛县人民医院收治的60例重症有机磷农药中毒致呼吸衰竭患者,按随机数字表法分为对照组(30例,常规治疗)和研究组(30例,在常规治疗的基础上联合急诊呼吸机治疗),治疗周期为7 d。比较两组患者意识恢复时间、自主呼吸恢复时间、住院时间,治疗前后血气分析指标及阿托品用量、治愈率、阿托品中毒率。结果研究组患者意识恢复时间、住院时间及自主呼吸恢复时间均短于对照组;与治疗前比,治疗后两组患者PaO2水平升高,且研究组高于对照组;PaCO2水平、pH值降低,且研究组低于对照组;研究组患者阿托品用量低于对照组,治愈率高于对照组,阿托品中毒率低于对照组(均P<0.05)。结论急性重症有机磷农药中毒致呼吸衰竭加用呼吸机进行辅助呼吸可通过调节PaO2、PaCO2水平、pH值有效改善患者的肺功能,减少阿托品用量,避免阿托品中毒,提高治愈率,加速康复进程。

Objective To investigate the effect of emergency ventilator on blood gas analysis indexes of patients with respiratory failure caused by severe organophosphorus pesticide poisoning. Methods From October 2014 to November 2019, 60 patients with respiratory failure caused by severe organophosphorus pesticide poisoning were selected from the Peixian People’s Hospital and divided into the control group(30 cases, conventional treatment) and the study group(30 cases, combined with emergency ventilator therapy on the basis of conventional treatment) according to the random number table, the treatment cycle was 7 days. The consciousness recovery time, spontaneous breathing recovery time, hospitalization time, blood gas analysis indexes before and after treatment, atropine dosage, cure rate and atropine poisoning rate were compared between the two groups. Results The recovery time of consciousness, hospitalization and spontaneous breathing of the study group were shorter than those of the control group;Compared with before treatment, the PaO2 level of the two groups of patients increased after treatment, and the study group was higher than the control group;PaCO2 level and pH value decreased, and the study group was lower than the control group;The consumption of atropine in the study group was lower than that of the control group, the cure rate was higher than that of the control group, and the atropine poisoning rate was lower than that of the control group(all P<0.05). Conclusion Acute severe organophosphorus pesticide poisoning causes respiratory failure and assisted breathing with a ventilator can effectively improve the patient’s lung function by adjusting PaO2, PaCO2 levels, and pH value, reducing the amount of atropine, avoiding atropine poisoning, increasing the cure rate, and accelerating the recovery process.