急诊雾化吸入气道内给药治疗急性三氯化磷吸入性呼吸道损伤  

Intratracheal medication by aerosol rebreathing method in emergency treatment of acute respiratory tract injury caused by inhalation of phosphorus trichloride

作　　者：王忠[1] 吴学豪[1] 夏欣一[2] 孙海晨[1] 

机构地区：[1]南京军区南京总医院急救医学科,江苏南京210002 [2]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002

出　　处：《医学研究生学报》2008年第9期942-943,947,共3页Journal of Medical Postgraduates

基　　金：江苏省135工程重点学科基金资助项目(批准号:2001034)

摘　　要：目的：探讨急性三氯化磷吸入性呼吸道损伤的急诊救治方法。方法：总结和分析16例急性三氯化磷吸入性呼吸道损伤的临床资料。急诊明确诊断后立即予沙丁胺醇雾化液和布地奈德雾化液雾化气管内给药（1次/12h，10-15 min/次），疗程3-5 d，同时予以抗炎、补液和其他对症治疗。结果：雾化吸入治疗3-5次后显效率显著提高。16例患者治愈15例，好转1例，无死亡，治愈率为93.75%；最短留观治疗2 d，最长7 d，平均2.38 d；所有患者均经3个月的随访，仅1例留有胸膜增厚外，无慢性咳嗽或其他后遗症。结论：早期、局部、短程应用肾上腺糖皮质激素布地奈德雾化液合并β2受体激动剂沙丁胺醇雾化液雾化气管内给药急诊治疗急性三氯化磷吸入性呼吸道损伤起效快、疗效好、不良反应少，该方法简便、实用、经济，患者易于接受，不受年龄和病史限制。Objective： To explore the emergency treatment of acute respiratory tract injury caused by inhalation of phosphorus trichloride. Methods： The clinical data of 16 patients with acute respiratory tract injury caused by inhalation of phosphorus trichloride were analyzed. Intratracheal inhalation of salbutamol sulfate solution and pulmicort repules atomized liquid by aerosol rebreathing method was performed immediately after the diagnosis was made. Anti-inflammatory, fluid replacement, and other symptomatic treatment were given at the same time. Treatment lasted for 3-5 days. Results： The symptoms and signs improved significantly after 3-5 times of inhalation. Among the 16 patients, 15 were cured and one improved; the cure rate was 93.75%. The shortest observation period was 2 days and the longest 7 days with an average period of 2.38 days. All cases were followed up for 3 months. No complications were found except one with pleural thickening. Conclusion： Early treatment of acute respiratory tract injury with intratracheal corticosteroid andβ2 receptor of phosphorus trichloride. The method is fast-acting, activator is satisfactory for patients with inhalation efficient, with less side-effects, convenient, and easily accepted by patients.

关 键 词：三氯化磷 急性肺损伤 糖皮质激素 吸入 

分 类 号：R595[医药卫生—内科学]