大黄不同给药方法在重度急性有机磷农药中毒患者中的应用  

Application of different administration methods of rhubarb in patients with severe acute organophosphorus pesticide poisoning

作　　者：卢涵婧 李海 赖纪英 刘先发[1] LU Hanjing;LI Hai;LAI Jiying;LIU Xianfa(Department of Emergency;Department of Rehabilitation,The First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi 341000,China)

机构地区：[1]赣南医学院第一附属医院急诊科,江西赣州341000 [2]赣南医学院第一附属医院康复科,江西赣州341000

出　　处：《检验医学与临床》2023年第11期1536-1539,1543,共5页Laboratory Medicine and Clinic

基　　金：江西省中医药管理局科技计划项目(2022B706)。

摘　　要：目的比较大黄不同给药方法在重度急性有机磷农药中毒(AOPP)患者中的应用效果。方法选择2018年1月至2022年6月该院收治的重度AOPP患者60例,随机分为对照组、鼻饲组和灌肠组,每组20例。对照组给予常规治疗,鼻饲组在常规治疗基础上接受大黄鼻饲治疗,灌肠组在常规治疗基础上采用大黄保留灌肠治疗。比较3组患者治疗前、治疗3 d后血清丙氨酸氨基转移酶(ALT)、淀粉酶(AMS)、肌酐(Cr)水平,以及并发症发生情况、康复情况、治疗后简明健康状况调查问卷(SF-36量表)评分等。结果与治疗前比较,3组患者治疗3 d后血清ALT、AMS、Cr水平均降低,且鼻饲组、灌肠组均低于对照组,鼻饲组低于灌肠组,差异均有统计学意义(P<0.05);3组患者中间综合征等并发症发生情况、通气时间比较,差异均无统计学意义(P>0.05);鼻饲组、灌肠组患者苏醒时间、胆碱酯酶恢复时间、住院时间均短于对照组,且鼻饲组短于灌肠组,差异均有统计学意义(P<0.05);鼻饲组、灌肠组患者治疗后SF-36量表各维度评分均高于对照组,且鼻饲组高于灌肠组,差异均有统计学意义(P<0.05)。结论采用大黄鼻饲和保留灌肠治疗重度AOPP均具有较好的临床疗效,能改善患者血清ALT、AMS、Cr水平,缩短其康复所用时间,提高患者生活质量。Objective To compare the application effect of different administration methods of rhubarb in patients with severe acute organophosphorus pesticide poisoning(AOPP).Methods A total of 60 patients with severe AOPP admitted to this hospital from January 2018 to June 2022 were selected and randomly divided into the control group,the nasal feeding group and the enema group,with 20 cases in each group.The control group received conventional treatment,the nasal feeding group received rhubarb nasal feeding on the basis of the conventional treatment,and the enema group received rhubarb retention enema on the basis of the conventional treatment.The levels of alanine aminotransferase(ALT),amylase(AMS)and creatinine(Cr)were compared among the 3 groups before and after 3 days of treatment,and the complications,recovery and scores of the Concise Health Status Scale(SF-36 scale)after treatment were compared among the 3 groups.Results Compared with before treatment,the levels of serum ALT,AMS and Cr in the 3 groups were decreased after 3 days of treatment,and those in the nasal feeding group and the enema group were shorter than those in the control group,and those in the nasal feeding group were shorter than those in the enema group,the differences were statistically significant(P<0.05).There were no significant differences in the occurrence of complications such as intermediate syndrome and ventilation time among the 3 groups(P>0.05).The recovery time,cholinesterase recovery time and hospitalization time of the nasal feeding group and enema group were shorter than those of the control group,and those in the nasal feeding group were shorter than those in the enema group,the differences were statistically significant(P<0.05).After treatment,scores of all dimensions of SF-36 scale in nasal feeding group and enema group were higher than those in the control group,and those in the nasal feeding group were higher than those in enema group,the differences were statistically significant(P<0.05).Conclusion Rhubarb nasal feeding and ret

关 键 词：急性有机磷农药中毒 并发症 大黄 

分 类 号：R595.4[医药卫生—内科学]