早期强化导泻治疗急性有机磷农药中毒的疗效研究  

Study on effect of early enhanced catharsis for treating acute organophosphorus pesticide poisoning

作　　者：秦勇[1] 简华刚[2] 黄圣杰 王娟[1] 王金龙[1] QIN Yong;JIAN Huagang;HUANG Shengjie;WANG Juan;WANG Jinlong(Department of Emergency,Fuling Central Hospital,Chongqing 408000,China;Department of Emergency,Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆市涪陵中心医院急救部,408000 [2]重庆医科大学附属第二医院急救部,400010

出　　处：《重庆医学》2021年第11期1866-1869,共4页Chongqing medicine

基　　金：重庆市涪陵区科技局科研项目(FLKJ-2018BBB3022)。

摘　　要：目的观察鼻饲甘露醇联合生大黄浸泡液保留灌肠强化导泻对急性口服有机磷农药中毒(AOPP)的临床疗效。方法选取2017年1月至2019年12月重庆市涪陵中心医院急救部收治的104例AOPP患者为研究对象,分为强化导泻组和常规导泻组。强化导泻组采用20%甘露醇胃管注入联合生大黄浸泡液保留灌肠强化导泻,常规导泻组采用20%甘露醇胃管注入导泻。观察并比较两组入院至首次出现腹泻时间、血清胆碱酯酶、C反应蛋白(CRP)、住院时间和费用。结果与常规导泻组比较,强化导泻组入院至出现首次腹泻时间明显缩短,入院48 h CRP水平降低、胆碱酯酶水平升高,住院时间缩短,住院费用降低,差异有统计学意义(P<0.05)。结论早期强化导泻治疗方案有助于AOPP治疗。Objective To observe the clinical efficacy of nasal feeding mannitol combined with raw rhubarb soaking liquid retention enema and enhanced catharsis on acute oral organophosphorus pesticide poisoning(AOPP).Methods A total of 104 patients with AOPP admitted to the emergency department of Chongqing Fuling Central Hospital from January 2017 to December 2019 were selected as the study subjects and divided into the enhanced catharsis group and conventional catharsis group.The enhanced catharsis group adopted 20%mannitol gastric tube infusion combined with raw rhubarb soaking solution retention enema was used to intensify the catharsis,while the conventional catharsis group was injected with 20%mannitol by gastric tube for the catharsis.The time from admission to the first appearance of diarrhea,serum cholinesterase,C-reactive protein(CRP),length of hospital stay and expenses were compared between the two groups.Results Compared with the conventional catharsis group,the time from admission to the first diarrhea in the enhanced catharsis group was significantly shortened,the CRP level at 48 h after admission was decreased,the cholinesterase level was increased,the length of hospitalization was shortened,and the cost of hospitalization was reduced,and the differences were statistically significant(P<0.05).Conclusion Early enhanced catharsis treatment protocol could help the AOPP treatment.

关 键 词：有机磷农药中毒 导泻 甘露醇 生大黄 C反应蛋白 胆碱酯酶 

分 类 号：R453.9[医药卫生—治疗学]