持续低压洗胃法在有机磷农药中毒患者洗胃治疗中的应用  

Application of continuous low-pressure gastric lavage in gastric lavage treatment of organophosphorus pesticide poisoning patients

作　　者：谭金波 李剑 李德忠 邹振武 TAN Jin-bo;LI Jian;LIi De-zhong;ZOU Zhen-wu(Enshi Tujia and Miao Autonomous Prefecture Central Hospital Department of Emergency Surgery,44560)

机构地区：[1]恩施土家族苗族自治州中心医院西医部急诊外科,湖北445600

出　　处：《中国急救复苏与灾害医学杂志》2018年第8期727-730,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨持续低压洗胃法在重度有机磷农药中毒患者洗胃治疗中的应用价值。方法选取2014年1月-2015年12月恩施土家族苗族自治州中心医院急诊科收治的60例重度有机磷农药重度患者，其中30例患者（观察组）采用常规洗胃进行第1次洗胃、鼻胃管接低压多功能引流袋进行第2次洗胃，30例患者（对照组）第1次及第2次洗胃均采用常规洗胃方法，对比2组患者的治疗效果。结果观察组患者的阿托品用量、昏迷时间、住院时间均显著低于对照组（P〈0．05）；治疗48h后，观察组的二氧化碳分压（PaCO2）、肌酐（Cr）、APACHEⅡ评分显著的低于对照组（P〈0．05）；第2次洗胃时，观察组患者烦躁不安、不合作发生率显著低于对照组（P〈0．05），洗胃后，观察组胃黏膜损伤发生率显著低于对照组（P〈0．05）；治疗前，两组患者的全血胆碱酯酶活性（BuChE）水平差异无统计学意义（P〉0．05）；治疗24、48、72h各时点，观察组的BuChE水平显著高于对照组（P〈0．05）。结论持续低压洗胃法在重度有机磷农药中毒患者洗胃治疗中有助于减少阿托品用量，对患者的救治具有积极作用。Objective To evaluate the value of continuous low-pressure gastric lavage in patients with severe organophosphorus pesticide poisoning. Methods Sixty patients with severe organophosphorus pesticide were enrolled in our hospital emergency department （January 2014 to December 2015）. Among them, 30 patients （observation group） were treated with gastric lavage for the first time. Functional drainage bag for the second gastric lavage, 30 patients （control group） the first and second gastric lavage are used conventional gastric lavage method, compared the two groups of patients with therapeutic effect. Results Patients in the observation group, the dosage of atropine coma time and hospitalization time were significantly lower than the control group （P 〈0.05）; after 48 h treatment, the observation group PaCO2, Cr, APACHE score was significantly lower than that of control group （P 〈0.05）, the observation group PaO2 was significantly higher than that of control group （P 〈0.05）; second gastric lavage, observation patients with anxiety, the incidence was significantly lower than the control group （P 〈0.05）, non cooperation after gastric lavage, gastric mucosal injury incidence rate of observation group was significantly lower than the control group （P 〈0.05）; before treatment, there were no significant differences in BuChE level of two groups of patients （P 〉0.05）; 24 h, 48 h, 72h after treatment, the observation group the level of BuChE was significantly higher than that of control group （P 〈 0.05）.Conclusion Continuous low-pressure gastric lavage therapy in patients with severe organophosphorus pesticide gastric lavage treatment can help reduce the amount of atropine, the patient＇s treatment has a positive effect.

关 键 词：低压多功能引流袋 重度 有机磷农药中毒 洗胃 

分 类 号：R459.7[医药卫生—急诊医学]