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目的探讨胃肠道去污染干预对无起始症状型中毒病人的临床预后的影响。方法回顾性分析1999年1月至2006年12月期间627例无起始症状型中毒病例,比较胃肠道去污染(洗胃和活性炭)干预与否对急诊留观时间、气管插管率、并发症发生率等临床预后指标的影响。结果干预组和对照组比较气管插管率差异无统计学意义(6.5%vs 5.3%,P=0.51),干预组急诊留观时间明显延长[(11.2±4.7)vs(8.9±5.0),P<0.001],并发症的发生率也显著增加(6.5%vs 2.5%,P=0.01)。无起始症状型中毒病例中非毒物摄入组和延迟性中毒组两组间胃肠道去污染干预率差异无统计学意义(x~2=2.32,P=0.51)。结论洗胃和活性炭等胃肠道去污染干预措施并不能显著改善无起始症状型中毒患者的临床预后,且干预组并发症发生率和急诊留观时间显著增加;对无起始症状型中毒患者临床上很可能存在过度干预。
Objective To investigate the effects of gastrointestinal decontamination on the clinical prognosis of patients without initial symptoms of poisoning. Methods A retrospective analysis of 627 cases of non-onset symptoms poisoned between January 1999 and December 2006 was conducted. The effects of gastrointestinal decontamination (gastric lavage and activated carbon) intervention on the time of emergency observation, tracheal intubation rate, Complications and other clinical prognostic indicators. Results There was no significant difference in tracheal intubation rate between the intervention group and the control group (6.5% vs 5.3%, P = 0.51), and the prolonged stay in the intervention group was significantly longer (11.2 ± 4.7 vs 8.9 ± 5.0, P <0.001]. The incidence of complications was also significantly increased (6.5% vs 2.5%, P = 0.01). There was no significant difference in the rate of gastrointestinal decontamination between the two groups without non-toxic and non-poisoned patients (x ~ 2 = 2.32, P = 0.51). Conclusion Gastrointestinal decontamination intervention such as gastric lavage and activated charcoal can not significantly improve the clinical prognosis of patients without initial symptomatic poisoning, and the incidence of complications and emergency observation time in the intervention group were significantly increased. For the patients without initial symptomatic poisoning Patients are likely to have excessive clinical intervention.