优化急救流程对急性重度有机磷农药中毒患者的影响分析

Analysis of effect of emergency process optimization on patients with acute severe organophosphorus pesticide poisoning

目的探讨优化急救流程对急性重度有机磷农药中毒患者的影响。方法以2021年11月南京医科大学第一附属医院优化急救流程为分界线,将2019年10月—2021年10月实施常规急救模式的67例急性重度有机磷农药中毒患者归为对照组,2021年11月—2023年11月实施优化后急救流程的69例急性重度有机磷农药中毒患者归为观察组。比较两组救治时间,临床症状消失时间,并发症发生率,预后评分[格拉斯哥昏迷指数(GCS)评分、急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分]和患者护理满意度。结果观察组胆碱酯酶活力恢复时间、应用呼吸机时间和住院时间显著低于对照组(P<0.05),但两组间阿托品化时间和清洁肠道时间差异无统计意义(P>0.05);观察组恶心呕吐、瞳孔异常、全身抽搐、昏迷和呼吸紧促时间显著低于对照组(P<0.05);观察组并发症发生率为2.90%,显著低于对照组的11.94%(P<0.05);观察组GCS评分显著高于对照组,APACHEⅡ评分显著低于对照组(P<0.05);观察组护理满意度评分显著高于对照组(P<0.05)。结论优化急救流程可以缩短急性重度有机磷农药中毒患者救治时间和临床症状消退时间,减少并发症发生率,改善预后,提高护理满意度。

Objective To analyze the effect of emergency process optimization on patients with acute severe organophosphorus pesticide poisoning.Methods Taking the implementation of emergency process optimization in the hospital in November 2021 as the dividing line,67 patients with acute severe organophosphorus pesticide poisoning who received routine emergency model from October 2019 to October 2021 were classified as control group,and 69 patients with acute severe organophosphorus pesticide poisoning who carried out emergency process optimization from November 2021 to November 2023 were enrolled as observation group.The treatment time,disappearance time of each clinical symptom,incidence rates of complications,prognosis score[Glasgow Coma Scale(GCS),Acute Physiology and Chronic Health Evaluation II(APACHE II)]and patient nursing satisfaction were compared between both groups.Results The recovery time of cholinesterase activity,ventilator application time and hospital stay in observation group were significantly shorter than those in control group(P<0.05),but there were no statistical differences in atropinization time and intestinal cleaning time between the two groups(P>0.05).The disappearance times of nausea and vomiting,pupil abnormality,general convulsion,coma and shortness of breath in observation group were significantly shorter compared with those in control group(P<0.05).The total incidence rate of complications in observation group(2.90%)was significantly lower than that in control group(11.94%)(P<0.05).GCS score in observation group was significantly higher than that in control group,the APACHE II score was significantly lower than that in control group(P<0.05).Nursing satisfaction scores in observation group were significantly higher than those in control group(P<0.05).Conclusion Optimizing emergency care processes can shorten the treatment time and the resolution time of clinical symptoms in patients with acute severe organophosphorus pesticide poisoning,reduce the incidence of complications,improve prognosis,and enhance patient care satisfaction.