解胃磷合剂治疗有机磷农药中毒病例的效果探究

Research on the Effect of Jiewei Phosphorus Mixture on Organophosphorus Pesticide Poisoning Cases

目的分析解胃磷合剂治疗有机磷农药中毒的临床效果。方法从2015年1月—2019年11月阶段该院急诊科接收的有机磷农药中毒患者中选取104例,根据治疗方法分为观察组和对照组,其中观察组包括51例患者,对照组包括53例患者。两组患者入院后均立即给予洗胃,观察组患者在第一次洗胃完成后,经胃管注入解胃磷合剂,对照组患者则视患者具体情况给予3~4次洗胃治疗。在此基础上同时给予阿托品、氯磷定、保肝治疗和对症治疗,其中阿托品和复能剂的用量要根据患者的具体情况决定,对于呼吸衰竭的患者,给予呼吸机治疗。比较两组成功抢救患者的抢救48 h的各项指标评分、患者的并发症发生率和患者的抢救成功率。结果与对照组成功抢救患者相比,观察组成功抢救患者抢救48 h的生命体征平稳、意识恢复、临床中毒症状消失、全血胆碱酯酶活性≥70%、重要器官功能无损害等评分明显更高,比较差异有统计学意义(t=4.257、6.674、6.927、7.056、8.675,P<0.05)。与对照组成功抢救患者41.30%的脑水肿、肺水肿、院内感染、MODS并发症发生率相比,观察组成功抢救患者的18.00%明显更低,比较差异有统计学意义(χ^2=6.289,P<0.05)。相比对照组86.79%(46/53)的抢救成功率,观察组患者的98.04%(50/51)明显更高,比较差异有统计学意义(χ^2=4.630,P<0.05)。结论在有机磷农药中毒患者的急诊抢救治疗中应用解胃磷合剂,能够显著在较短的时间内促进患者中毒症状的改善,提高患者的急救效率,并能够有效控制并发症的发生,显著提高患者的抢救成功率。

Objective Analysis of the clinical effect of Jiewei phosphorus mixture in the treatment of organophosphorus pesticide poisoning.Methods From January 2015 to November 2019,104 patients with organophosphorus pesticide poisoning received by the emergency department of the hospital were divided into observation group and control group according to the treatment method,including 51 patients in the observation group and 53 patients in the control group.Both groups were given gastric lavage immediately after admission.After the first gastric lavage,the patients in the observation group were injected with Jiewei phosphorus mixture through gastric tube,while the patients in the control group were given gastric lavage 3-4 times depending on the specific situation of the patients.On this basis,atropine,chlorophosphoridine,liver protection and symptomatic treatment were given at the same time.The dosage of atropine and energy recovery agent should be determined according to the specific situation of the patients,and the patients with dyspnea should be given ventilator treatment.The successfully rescued patients's index scores of 48 hours,the incidence of complications and the success rate of rescue were compared between the two groups.Results Compared with successfully rescued patients in the control group,the scores of vital signs,consciousness recovery,clinical poisoning symptom disappearance,whole blood cholinesterase activity≥70%and important organ function no damage in the observation group were significantly higher,the difference was statistically significant(t=4.257,6.674,6.927,7.056,8.675,P<0.05).Compared with 41.30%of the successfully rescued patients in the control group,the incidence of brain edema,pulmonary edema,nosocomial infection and MODS complications in the observation group was 18.00%,significantly lower(χ2=6.289,P<0.05).Compared with 86.79%(46/53)in the control group,98.04%(50/51)in the observation group was significantly higher,the difference was statistically significant(χ2=6.289,P<0.05).Conclusion The application of Jiewei phosphorus mixture in the emergency treatment of organophosphorus pesticide poisoning can significantly improve the symptoms of poisoning in a short time,improve the efficiency of emergency treatment, effectively control the occurrence of complications, and significantly improve the success rate of rescue.