不同时间进食对急性口服有机磷农药中毒患者预后的影响  

Effects of food intake at different times on the prognosis of 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,Shandong,256600;Department of Emergency,Binzhou Medical University Hospital,Binzhou,Shandong,256603)

机构地区：[1]滨州医学院,山东滨州256600 [2]滨州医学院附属医院急症科,山东滨州256603

出　　处：《中西医结合护理（中英文）》2019年第12期34-38,共5页Journal of Clinical Nursing in Practice

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

摘　　要：目的探讨不同时间进食对急性口服有机磷农药中毒患者预后的影响。方法采用前瞻性研究法,选取某三甲医院2018年1月-2019年7月收治的128例急性口服有机磷中毒患者,按照中毒后进食时间的不同将患者分为A、B、C、D组,A组为中毒后<6 h进食组;B组为中毒后6~<12 h进食组;C组为中毒后12~<24 h进食组;D组为中毒后≥24 h进食组。监测患者中毒后24、48、72、120 h的胆碱酯酶水平,记录肝损害、肾损害、心肌损害、中毒后反跳等并发症的发生率,以及进食后胃肠道反应发生率和住院时间。结果中毒后24、48、72、120 h胆碱酯酶检测结果显示,A组患者胆碱酯酶水平恢复情况优于其他3组(P<0.05)。A组患者住院时间较其他3组短(P<0.01)。4组患者进食后出现胃肠道反应、中毒后反跳、肝损伤、肾损伤、心肌损伤的发生率比较,差异无统计学意义(P>0.05)。结论急性口服有机磷中毒患者早期进食的最佳时间为6 h内。进食时间越早,患者恢复越快,住院时间缩短,且不增加胃肠道反应、中毒后反跳、肝损伤、肾损伤、心肌损伤的发生风险。Objective To investigate the effect of food intake at different times on the prognosis of patients with acute oral organophosphorus pesticide poisoning, in order to obtain the best time for early feeding. Methods The prospective study method was adopted to select 128 cases of patients with acute oral organophosphorus poisoning admitted to a grade A hospital from January 2018 to August 2019. According to the different feeding time after admission, the patients were divided into four groups: A, B, C and D. Patients in group A were fed within 6 hours after poisoning. Patients in group B were fed within 6-12 h after poisoning. Patients in group C were fed within 12-24 h after poisoning. Patients in group D were fed 24 hours after poisoning. All the patients were able to obtain food after admission, and the feeding methods were consistent. The cholinesterase activity of patients was observed at 24 h, 48 h, 72 h and 120 h after poisoning. The incidence rates of liver damage, kidney damage, myocardial damage, rebound after poisoning, gastrointestinal reactions after food intake and hospital stay were compared among four groups. Results There was a better improvement of cholinesterase activity in the group A compared with that in other 3 groups(P<0.05). The length of stay in the group A was shorter than the other 3 groups(P<0.01). There were no significant differences in the incidence rates of gastrointestinal reactions after food intake, rebound after poisoning, liver injury, kidney injury and myocardial injury among 4 groups(P>0.05). Conclusion It is suggested to feed patients with acute oral organophosphorus poisoning within 6 h after poisoning. The earlier the time of food intake, the faster the recovery, the shorter the hospital stay, and early food intake may not increase the risk of gastrointestinal reactions, rebound after poisoning, liver injury, kidney injury, myocardial injury.

关 键 词：口服中毒 有机磷农药中毒 早期进食 进食时间 

分 类 号：R472.2[医药卫生—急诊医学]