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目的观察早期活性炭胃肠吸附疗法对口服急性有机磷中毒(AOPP)的治疗作用。方法选择本省农药中毒高发区的6家医院开展多中心临床研究。279例口服AOPP患者分为162例对照组和117例活性炭灌服组,对照组给予常规规范化治疗,灌服组在常规规范治疗基础上增加活性炭灌服治疗。结果 2组比较,活性炭灌服组阿托品、氯磷定用量明显减少(u=4.77与4.43,P<0.05),住院时间明显缩短(u=7.88,P<0.01);但中间期肌无力综合征(IMS)发生率、病死率差异无统计学意义(2=0.61或0.14,P>0.05)。根据活性炭应用次数分层分析,活性炭应用次数≥2次与应用1次组比较,氯磷定的用量减少(t’=2.46,P<0.05),住院时间明显缩短(t’=3.27,P<0.01),无死亡病例发生。结论本组病例观察到早期活性炭胃肠吸附疗法对口服急性AOPP有一定治疗作用,反复应用疗效较好。
Objective To observe the therapeutic effect of early activated carbon gastrointestinal absorption therapy on oral acute organophosphorus poisoning (AOPP). Methods Six hospitals in the high incidence area of pesticide poisoning in our province were selected to carry out multi-center clinical research. 279 cases of oral AOPP patients were divided into 162 cases of control group and 117 cases of active carbon treatment group, the control group given conventional normative treatment, gavage group in the conventional norms of treatment based on the increase of activated carbon irrigation treatment. Results Compared with the control group, the doses of atropine and chlorophoridine in activated carbon were significantly decreased (u = 4.77 and 4.43, P <0.05), and the hospital stay was significantly shorter (u = 7.88, P <0.01) (IMS) incidence and mortality did not differ significantly (2 = 0.61 or 0.14, P> 0.05). According to the stratified analysis of the number of activated carbon application, the amount of application of chlorophosphorus decreased (t ’= 2.46, P <0.05) and the length of hospital stay significantly shorter (t’ = 3.27, P < 0.01), no deaths occurred. Conclusion This group of patients observed early activated carbon gastrointestinal adsorption therapy for acute oral AOPP have a therapeutic effect, repeated use of good effect.