急性有机磷农药中毒氧利用率研究  

Study of alteration oxygen utilization coefficient （O2UC） in patients with acute organophosphorus poisoning

作　　者：颜鲲[1] 杨季[1] 

机构地区：[1]中南大学湘雅三医院急诊科,湖南长沙410013

出　　处：《世界急危重病医学杂志》2006年第1期1068-1070,1077,共4页internationl journal of emergency and critical care medicine

摘　　要：目的探讨急性有机磷农药中毒患者氧利用率的变化及与预后的关系。方法①将135例急性有机磷农药中毒患者分为轻中度中毒组（A组，72例）、重度中毒组（B组，63例）；另设正常对照组（C组，40例）。（④A、B组患者于急诊入院和住院后1、2、3、5、7、10d分别于8：00时抽取动静脉血查血气分析并计算氧利用率。C组仅做一次血气分析并计算其氧利用率。结果①急诊入院时和入院第1d，A、B组氧利用率均高于C组（A组：0．4026±0．0926，0．3912±0．0765。B组：0．4328±0．0899，0．4177±0．0759。C组：0．3152±0．0192，P〈0．01）。而A、B组无明显差异（P〉0．05）。氧利用率持续高于0．57时，病人多于短期内死产。②从住院第2d起，A与B组氧利用率均快速下降，并低于C组（P〈0．05），且B组较A组下降明显（P〈0．05）。A组于入院第5d氧利用率逐渐回升并恢复正常。而B组氧利用率持续低于C组（P〈0．01）。当氧利用率持续低于0．21。提示预后不良。结论有机磷农药中毒患者存在较低的氧利用率。氧利用率可作为判断有机磷农药中毒患者组织缺氧、病情严重程度和评估预后的指标。Objective To investigate relationship between prognosis and alteration oxygen utilization coefficient（O2UC）in patients with acute organophosphorus poisoning. Methods ① 135 patients were subdivided into mild intoxication groups （Group A, patients of 72 ）and severe intoxication groups （Groups B, patients of 63）, and 40 normal subject group （Group C） were selected for comparism. ②Gas analysis of arterial blood and central venous blood and calculation of O2UC[O2UC=（SaO2-SvO2/SaO2] were carried out in group A and group B on admission and 1,2,3,5,7,10 days after admission, and which was carried out only in group C. Results ②On admission and 1 day after admission,O2UC in group A （0.4026±0.0926 and 0.3912±0.0765） and group B （0.4328±0.0899,0.4177±0.0759） were significantly higher than that of group C （0.3152±0.0192 ,P〈0.01）, but O2UC in group B were not significantly different from those in group A（P〉0.05）. When O2UC persisted high 0.57, the prognosis of the patients was died in short time. ②From beginning with 2 days after admission ,O2UC in group A and group B declined quickly and were lower than that in group C （P〈0.05）, and O2UC in group B were obviously lower than those in group A （P〈0.01 or P〈 0.05）.From 5 days after admission, O2UC in group A were then improve and were not significantly different from that in group C （P〉0.05）, but O2UC in group B remain at a lower level （compared with group C, P〈 0.01）. When O2UC in patients with severe intoxication persisted to decrease below 0.21 and maintained for a long time, there were higher death rate and the prognosis was bad also. Conclusion O2UC in patients with acute organophosphorus poisoning is frequently lower .This predicts more sever condition ,worse prognosis. O2UC is a effective, sensible and convenient predictor in the monitor and treatment of acute organophosphorus poisoning patients.

关 键 词：有机磷农药中毒 急性 氧利用率 预后 

分 类 号：R595.51[医药卫生—内科学]