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目的探讨口服有机磷农药重度中毒(AOPP)病人的胃肠道清洁优化方法。方法把不同期收治的AOPP病人进行分组对照。优化组66例,在常规首次充分洗胃的基础上,留置胃管间断洗胃、持续胃肠减压;对照组60例,常规彻底洗胃、解毒药治疗。比较两组病人在治疗效果、解磷定和阿托品用量方面的差异性。结果优化组的治愈率高(P<0.05),“反跳”现象少(P<0.05),中间型综合征(IMS)发生率下降(P<0.05),胆碱酶(CHE)活力恢复至50%时间快(P<0.05);解磷定、阿托品用量少于对照组(P<0.01)。结论经优化的胃肠道清洁法,可及时有效清除AOPP病人胃肠道的毒物,提高治疗效果,减少临床用药和并发症的发生,适于临床推广应用。
Objective To investigate the optimization of gastrointestinal tract cleaning in patients with severe organophosphorus pesticide poisoning (AOPP). Methods AOPP patients treated in different periods were grouped and controlled. In the optimized group of 66 cases, gastric lavage was performed intermittently on the basis of adequate lavage for the first time in a regular way, and the gastrointestinal decompression was continued. In the control group, 60 cases were treated with gastric lavage and antidote. The differences between the two groups in the treatment effect, phosphate and the amount of atropine were compared. Results The cure rate of optimized group was high (P <0.05), the phenomenon of “rebound” was less (P <0.05), the incidence of intermediate syndrome (IMS) Recovery time to 50% faster (P <0.05); Phosphorus detinate, atropine use less than the control group (P <0.01). Conclusion The optimized gastrointestinal tract cleaning method can effectively remove the gastrointestinal tract toxicants of AOPP patients in time and improve the curative effect and reduce the occurrence of clinical medication and complications and is suitable for clinical popularization and application.