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目的探讨急性敌敌畏中毒合并急性乙醇中毒患者重症胰腺炎发生情况,以指导临床早期诊断和合理治疗。方法将就诊于河北大学附属医院急诊科的140例急性重度敌敌畏中毒患者分为单纯敌敌畏中毒组(80例)、敌敌畏中毒合并乙醇中毒组(60例);于入院后24 h内通过血尿中淀粉酶、胰腺CT检查明确胰腺炎诊断;对2组患者胰腺炎发生率及其预后进行比较。结果急性敌敌畏中毒合并急性乙醇中毒患者20例发生重症胰腺炎,单纯敌敌畏中毒组14例发生重症胰腺炎,两组差异有统计学意义(χ2=4.67,P<0.05);混合中毒组胰腺炎患者并发症发生率、手术率、病死率、住院时间均高于单纯敌敌畏中毒组。结论与单纯敌敌畏中毒相比,急性敌敌畏中毒合并急性乙醇中毒患者更易发生重症胰腺炎,其病死率高,预后差。
Objective To investigate the incidence of severe pancreatitis in acute dichlorvos poisoning patients with acute alcoholism and to guide early clinical diagnosis and reasonable treatment. Methods A total of 140 patients with acute severe dichlorvos poisoning admitted to the emergency department of Affiliated Hospital of Hebei University were divided into simple dichlorvos poisoning group (80 cases) and dichlorvos poisoning group (60 cases). After 24 hours of admission, Enzyme and pancreatic CT examination confirmed the diagnosis of pancreatitis. The incidence of pancreatitis and its prognosis were compared between the two groups. Results Severe pancreatitis occurred in 20 patients with acute dichlorvos poisoning and acute ethanol poisoning, and severe pancreatitis in 14 patients with dichlorvos simple poisoning. There was significant difference between the two groups (χ2 = 4.67, P <0.05) The complication rate, operation rate, case fatality rate and hospital stay were all higher than those of pure dichlorvos poisoning group. Conclusion Compared with pure dichlorvos poisoning, acute dichlorvos poisoning patients with acute alcoholism are more likely to have severe pancreatitis with high mortality and poor prognosis.