急性有机磷农药中毒并发吸入性肺炎危险因素分析  

Analysis on risk factors of inducing aspiration pneumonia in the patients with acute organophosphorus pesticide poisoning

作　　者：赵义[1] 田质光 郭艳艳[1] 高夫海 王广军[1] 徐莺歌[1] 

机构地区：[1]江苏省徐州市第三人民医院中毒职业病科,徐州221005

出　　处：《中国急救复苏与灾害医学杂志》2016年第12期1172-1174,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨急性有机磷农药中毒（acuteorganicphosphoruspoisoning，AOPP）患者并发吸入性肺炎的危险因素。方法回顾性收集本院2013年1月～2016年3月收治的264例AOPP患者的临床资料，根据是否并发吸入性肺炎分为肺炎组和对照组，选取可能的危险因素先进行单因素分析，然后通过多元逐步Logistic回归分析确定其独立危险因素。结果264例AOPP中有42例患者并发吸入性肺炎，发生率达15．9％。单因素分析显示意识障碍、频繁呕吐、肌无力及洗胃不当为合并吸入性肺炎的危险因素；多元Logistic分析显示意识障碍、频繁呕吐、洗胃不当为独立危险因素，各因素的OR值及95％C1分别为：意识障碍52．522、（9．258—297．979），频繁呕吐10．048、（2．829—35．688），洗胃不当60．195、（12．122—298．928）。结论AOPP合并吸入性肺炎并不少见；意识障碍、频繁呕吐、洗胃不当是AOPP患者并发吸入性肺炎的独立危险因素；规范洗胃操作有可能减少AOPP并发吸入性肺炎的发生率。Abstract： Objective To investigate the risk factors of inducing aspiration pneumonia in patients with acute organophosphorus pesticide p0isoning（AOPP）. Methods The clinical data of 264 cases of AOPP, hospitalized in our hospital from January 2013 to March 2016, were retrospectively collected. The patients were divided into two groups, pneumonia group and control group, according to whether or not they were complicated by aspiration pneumonia. The risk factors were screened out with univariate analysis and multivariate stepwise logistic regression analysis. Results In264 cases of AOPP, 42 cases were complicated with aspiration pneumonia, the incidence rate was 15.9%. Univariate analysis showed that the disturbance of consciousness, frequent vomiting, amyosthenia and gastric lavage improper were the risk factors for aspiration pneumoniaMultivariate logistic analysis showed that the disturbance of consciousness, frequent vomiting and gastric lavage improper were the independent risk factors for complication of aspiration pneumonia in patients with AOPP, OR value and 95% CI respectively were： disturbance of consciousness 52.522 and 9.258-297.979, frequent vomiting 10.048 and 2.829-35.688, gastric lavage improper 60.195 and 12.122-298.928. Conclusion AOPP complicated with aspiration pneumonia is not uncommon, disturbance of consciousness, frequent vomiting, gastric lavage improper were independent risk factors for AoPP patients with aspiration pneumonia, standard operation of gastric lavage might reduce the incidence of aspiration pneumonia complicated with AOPP.

关 键 词：急性有机磷农药中毒 吸入性肺炎 危险因素 

分 类 号：R595.4[医药卫生—内科学]