内科联合急诊床边血液灌流治疗急性重度有机磷农药中毒致呼吸衰竭的疗效分析  

Efficacy analysis of internal medicine combined with emergency bedside hemoperfusion in acute respiratory failure caused by acute severe organophosphorus pesticide poisoning

作　　者：郭营波[1] GUO Yingbo(Department of Emergency,Central Hospital of Shengli Oilfield,Dongying 257000,Chin)

机构地区：[1]山东省胜利油田中心医院急诊科,山东东营257000

出　　处：《中国现代医生》2018年第18期88-90,共3页China Modern Doctor

摘　　要：目的探讨内科治疗措施联合急诊床边血液灌流治疗对急性重度有机磷农药中毒致呼吸衰竭患者的效果。方法选择2014年2月~2017年6月急性重度有机磷农药中毒致呼吸衰竭患者42例根据治疗方法分组。对照组给予单一内科治疗措施治疗,观察组则给予内科治疗措施联合急诊床边血液灌流治疗。比较两组急性重度有机磷农药中毒致呼吸衰竭抢救成功率;呼吸机支持时间、神志恢复时间、胆碱酯酶活力恢复时间、阿托品平均用量;治疗前后患者血清胆碱酯酶监测水平。结果观察组急性重度有机磷农药中毒致呼吸衰竭抢救成功率高于对照组(P<0.05);观察组呼吸机支持时间、神志恢复时间、胆碱酯酶活力恢复时间、阿托品平均用量低于对照组(P<0.05);治疗前两组血清胆碱酯酶监测水平相近(P>0.05);治疗后观察组血清胆碱酯酶监测水平优于对照组(P<0.05)。结论内科治疗措施联合急诊床边血液灌流治疗急性重度有机磷农药中毒致呼吸衰竭的应用效果确切,可有效改善患者预后,恢复神志状态,促使胆碱酯酶活力恢复,减少用药量和呼吸支持时间,值得推广应用。Objective To investigate the effect of internal medical treatment combined with emergency bedside hemop- effusion on patients with respiratory failure caused by acute severe organophosphorus pesticide poisoning. Methods 42 patients with respiratory failure caused by acute severe organophosphorus pesticide poisoning from February 2014 to June 2017 were selected and grouped according to treatment methods. The control group was given a single internal medical treatment, and the observation group was given internal medical treatment combined with emergency bedside hemopeffusion. The rescue success rate, ventilator support time, consciousness recovery time, recovery time of cholinesterase activity, and average atropine dosage; serum cholinesterase monitoring level before and after treatment in respiratory failure caused by acute severe organophosphorus pesticide poisoning were compared between the two groups. Results The rescue success rate of respiratory failure caused by acute severe organophosphorus pesticide poisoning in the observation group was higher than that in the control group（P〈0.05）. The ventilator support time, consciousness recovery time, recovery time of cholinesterase activity, and the average amount of atropine in the observation group were lower than those of the control group（P〈0.05）. The serum cholinesterase monitoring levels in two groups were similar before treatment（P〉0.05）. After treatment, the serum cholinesterase monitoring level of the observation group was better than that of the control group（P〈0.05）. Conclusion The medical treatment combined with emergency bedside hemoper fusion for the treatment of respiratory failure caused by acute severe organophosphorus pesticide poisoning has a definite effect. It can effectively improve the prognosis of patients, restore mental state, promote the recovery of cholinesterase activity, reduce the dosage and respiratory support time. And it is worth promoting.

关 键 词：急性重度有机磷农药中毒 呼吸衰竭 急诊急救措施 急诊床边血液灌流 胆碱酯酶 

分 类 号：R459.7[医药卫生—急诊医学]