不同时间进食对急性口服有机磷农药中毒患者治疗效果的观察  

Observation of the therapeutic effect of different time intake on patients with acute oral organophosphorus pesticide poisoning

作　　者：丛维红 颜琬华[1] 杜海岭[2] 杜绪强[2] 王香[2] 吴立强[2] 刘玉霞[2] Cong Weihong;Yan Wanhua;Du Hailing;Du Xuqiang;Wang Xiang;Wu Liqiang;Liu Yuxia(Binzhou Medical University,Binzhou 256600,China;Department of Emergency,the Affiliated Hospital of Binzhou Medical University,Binzhou 256600,China)

机构地区：[1]滨州医学院,256600 [2]滨州医学院附属医院急诊科,256600

出　　处：《中国实用护理杂志》2020年第4期247-251,共5页Chinese Journal of Practical Nursing

基　　金：滨州医学院附属医院护理部基金资助项目(BYFYHL-201802)。

摘　　要：目的探讨急性口服有机磷农药中毒患者早期进食的最佳时间。方法前瞻性研究2018年1月至2019年5月滨州医学附属医院急诊科收治的123例急性口服有机磷中毒患者,按照入院时中毒后进食时间的不同将患者分为A(中毒后<6 h开始进食)、B(中毒后≥6 h而<12 h开始进食)、C(中毒后≥12 h而<24 h开始进食)、D(中毒后≥24 h开始进食)4个进食组,4组患者均在入院时即可进食,方法一致。比较中毒后不同进食时间的患者24、48、72、120 h的胆碱酯酶活性,中毒后反跳发生率、临床中毒症状消失时间。结果A组患者在中毒后24、48、72、120 h的胆碱酯酶活性与其他3组比较,差异有统计学意义(H值为9.466~24.933,P<0.05或0.01);B、C、D3组间两两比较,差异无统计学意义(P>0.05)。4组患者中毒后反跳发生率分别为3.448%(1/30)、7.407%(2/29)、6.452%(2/33)、6.897%(2/31),差异无统计学意义(χ2值为0.431,P>0.05)。4组患者临床中毒症状消失时间比较,A组均短于其他3组,差异有统计学意义(H值为18.199,P<0.01)。结论急性口服有机磷农药中毒患者进食时间越早,胆碱酯酶活性恢复越快,中毒症状改善越早,且不增加胃肠道反应及中毒后反跳的发生率。早期进食的最佳时间为中毒后<6 h。Objective To study the best time of early feeding in patients with acute oral organophosphorus pesticide poisoning.Methods A prospective study was conducted on 123 patients with acute oral organophosphorus poisoning admitted from January 2018 to May 2019 in Department of Emergency,the Affiliated Hospital of Binzhou Medical University.The patients were divided into four groups,A(<6 h),B(≥6 h-<12 h),C(≥12 h-<24 h)and D(≥24 h),according to the time of poisoning at the time of admission.All the patients in the four groups were fed immediately upon admission with the same method.The cholinesterase activity at 24,48,72,120 h after poisoning,the incidence of rebound after poisoning,the disappearance time of clinical poisoning symptoms were compared among the four groups.Results Compared with the other three groups,group A had a statistically significant difference in the cholinesterase activity at 24,48,72,120 h after poisoning(H value was 9.466-24.933,P<0.05 or 0.01).There was no significant difference between the two groups in B,C,D group(P>0.05).The incidence of rebound after poisoning in A,B,C,D group was 3.448%(1/30),7.407%(2/29),6.452%(2/33),6.897%(2/31),respectively,with no statistically significant difference(χ2 value was 0.431,P>0.05).Compared with the four groups,the disappearance time of clinical poisoning symptoms in group A was shorter than that in the other three groups,and the difference was statistically significant(H value was18.199,P<0.05).Conclusions The earlier the patients ate,the faster the recovery of cholinesterase activity,the earlier the improvement of poisoning symptoms,and the incidence of gastrointestinal reaction and rebound after poisoning is not increased.The best time for early feeding is less than 6 h after poisoning.

关 键 词：口服 中毒 有机磷农药 早期进食 进食时间 

分 类 号：R5[医药卫生—内科学]