静脉应用利多卡因对有机磷中毒伴呼吸衰竭患者的影响  

Effect of lidocaine by intravenous drip on patients with organophosphorus intoxication and respiratory failure

作　　者：朱敏[1] 王斌[1] 

机构地区：[1]徐州市肿瘤医院重症监护科,江苏徐州221005

出　　处：《西部医学》2015年第12期1854-1856,共3页Medical Journal of West China

基　　金：徐州市推动科技创新项目(KC14SH013)

摘　　要：目的探讨静脉应用利多卡因对有机磷中毒伴呼吸衰竭患者的影响。方法选取我院急诊、ICU住院有机磷农药中毒并发呼吸衰竭患者64例,采用随机数字表法将64例患者分为观察组和对照组各32例。所有患者均接受常规治疗,观察组在此基础上静脉滴注利多卡因治疗,观察记录两组患者呼吸机相关性肺炎(VAP)发生率、呼吸机使用天数、住ICU天数,在使用呼吸机后48小时检测体温、血白细胞数、中性粒细胞百分比、痰培养结果、X线胸片结果及痰痂形成例数等。结果观察组和对照组分别有2例和3例死亡,两组间差异无统计学意义(P>0.05);两组分别有6例和14例发生VAP,VAP发生率分别为18.75%和43.75%,两组间差异有统计学意义(P<0.05)。观察组呼吸机使用天数、住ICU天数、使用呼吸机后48小时体温、血白细胞数、中性粒细胞百分比、痰培养阳性例数、胸片阳性例数和痰痂形成例数均低于对照组,差异均有统计学意义(均P<0.05)。结论有机磷中毒合并呼吸衰竭患者在早期即予以利多卡因,可有效降低呼吸机相关性肺炎的发生,减少呼吸机使用的时间及病人住ICU天数,值得临床推广使用。Objective To investigate the effect of lidocaine by intravenous drip on patients with organophosphorus intoxication and respiratory failure. Methods 64 patients with organophosphorus intoxication and respiratory failure were randomly divided into observation group and control group, 32 cases in each group. On the basis of conventional treatment, patients in observation group received lidocaine by intravenous drip. The ventilator-associated pneumonia （VAP） occurrence rate, days of using breathing machine, days in ICU, and body temperature, white blood cell count, neutrophile granulocyte percent, sputum culture, chest X-ray and sputum scab after using breathing machine for 48 h were recorded. Results There were 2 and 3 cases died in observation group and control group, respectively, without sig- nificant difference （P〉0. 05）. There were 6 and 14 cases with VAP in observation group and control group with signifi- cant difference （P〈0.05）. The body temperature, white blood cell count, neutrophile granulocyte percent, sputum cul- ture, chest X-ray and sputum scab after using breathing machine for 48 h of observation were significantly lower than that of control group with significant difference （P〈0.05）. Conclusion Early using lidocaine by intravenous drip on patients with organophosphorus intoxication and respiratory failure could effectively decrease the VAP occurrence rate, days of breathing machine and days in ICU.

关 键 词：有机磷中毒 呼吸衰竭 利多卡因 

分 类 号：R595.4[医药卫生—内科学]