不同院前急救模式对重度急性有机磷农药中毒患者的临床观察  

An observation of different pre-hospital care modes in severe acute organophosphorus pesticide poisoning patients

作　　者：李艳 LI Yan(Department of Emergency Medicine,Kaifeng Central Hospital,Kaifeng Henan 475000,China)

机构地区：[1]开封市中心医院急诊医学科,河南开封475000

出　　处：《临床研究》2023年第12期107-110,共4页Clinical Research

摘　　要：目的分析在重度急性有机磷农药中毒(SAOPP)患者中,不同院前急救模式干预效果。方法选取2021年1月至2022年6月开封市中心医院收治的70例SAOPP患者作为研究对象,根据时间段分组,将2021年1月至9月转送同时进行院前急救的患者设定为参照组,2021年10月至2022年6月先院前急救后院内治疗的患者设定为研究组,各35例,其中参照组以转送同时进行院前急救,研究组先院前急救,后转为院内进一步治疗。比较分析各组中患者抢救成功率、抢救成功治愈率、临床相关指标[血清胆碱酯酶(ChE)]恢复时间、症状消失时间、阿托品化时间、住院时间、碘解磷定用量、阿托品用量)、并发症情况(中间型综合征、呼吸衰竭、迟发神经损伤、心脏损害、阿托品中毒),以及皮质醇、促肾上腺素皮质激素水平、生活质量。结果研究组抢救成功率(91.43%)、抢救成功治愈率(96.88%)均高于参照组(71.43%、68.00%),差异有统计学意义(P<0.05)。研究组ChE恢复时间、症状消失时间、阿托品化时间、住院时间均短于参照组,且研究组碘解磷定用量、阿托品用量少于参照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于参照组,治疗后皮质醇与促肾上腺素皮质激素高于治疗前,差异有统计学意义(P<0.05)。治疗后研究组生活质量评分高于参照组,差异有统计学意义(P<0.05)。结论在SAOPP中以先急救后转运的模式,更利于提高治疗效果,提高患者生活质量、降低并发症。Objective To analyze the intervention effects of different pre-hospital care modes in severe acute organophosphorus pesticide poisoning(SAOPP)patients.Methods 70 patients with SAOPP who were admitted to the Central Hospital of Kaifeng City from January 2021 to June 2022 were selected as the research subjects.They were grouped according to the time period.Patients who were transferred and received pre-hospital emergency treatment at the same time from January 2021 to September 2021 were set as the reference group.Patients who received pre-hospital emergency treatment first and then inhospital treatment from October 2021 to June 2022 were set as the research group,each with 35 cases.In the reference group,prehospital emergency treatment was carried out at the same time as the transfer,while in the research group,pre-hospital emergency treatment was carried out first,followed by further in-hospital treatment.A comparative analysis was conducted on the success rate and recovery rate of patients in each group Clinical related indicators(ChE recovery time,symptom disappearance time,Atropine treatment time,hospital stay,dosage of Iodine Pralidoxime,dosage of Atropine),complications(intermediate syndrome,Respiratory failure,delayed nerve injury,heart damage,Atropine poisoning),cortisol,adrenocortical hormone levels,and quality of life.Results The success rate and cure rate of rescue in the study group accounted for 91.43%and 96.88%,respectively,which were higher than those in the reference group(71.43%and 68.00%).After comparison,there was a significant difference(P<0.05);The recovery time of ChE,the time of symptom disappearance,the time of hospitalization,and the time of Atropine transformation in the study group were shorter than those in the reference group.At the same time,the dosage of Pralidoxime iodide and Atropine was less,which was significantly different from the reference group(P<0.05);In addition,the incidence of complications is low,and the levels of cortisol and adrenocorticotropic hormone increase after t

关 键 词：有机磷农药中毒 重度 阿托品 胆碱酯酶 院前急救 

分 类 号：R139.3[医药卫生—劳动卫生]