急诊洗胃联合血液净化对精神类药物中毒的治疗分析  

Analysis of Emergency Gastric Lavage Combined with Blood Purification

作　　者：张潇月 李探 邵龙刚 刘克琴 ZHANG Xiao-yue;LI Tan;SHAO Long-gang;LIU Ke-qin(Department of Emergency,the Second Affi liated Hospital of Nanjing University of Traditional Chinese Medicine(Jiangsu Second Hospital of Traditional Chinese Medicine),Nanjing Jiangsu 210000,China)

机构地区：[1]南京中医药大学第二附属医院(江苏省第二中医院)急诊科,江苏南京210000

出　　处：《中华养生保健》2024年第8期1-4,共4页CHINESE HEALTH CARE

基　　金：江苏省中医药科技发展计划项目(MS2022042、MS2022036);南京市中西医结合疫病研究中心科研基金资助项目(NCMIC-2022-08);南京中医药大学自然科学基金项目(XZR2020052)。

摘　　要：目的探讨急诊洗胃和血液净化对急性重度精神类药物中毒的治疗价值。方法回顾性收集2017年1月—2023年1月江苏省第二中医院急诊科收治的85例急性重度精神类药物中毒患者的病历资料,根据患者的治疗方案分为保守治疗组、洗胃组、血液净化组、洗胃+血液净化组。收集各组患者的基本资料、洗胃及血液净化相关并发症发生率、预后相关指标等。结果收集的85例患者年龄分布在18~92岁,各组间的基线资料比较,差异无统计学意义(P>0.05)。与保守治疗组和血液净化组相比较,洗胃组和洗胃+血液净化组的洗胃相关并发症发生率显著升高,差异有统计学意义(P<0.05);与保守治疗组和洗胃组相比较,血液净化组和洗胃+血液净化组的坠积性肺炎、心脑血管意外的发生率更低,差异有统计学意义(P<0.05)。血液净化组和洗胃+血液净化组预后相关指标较保守治疗组和洗胃组均显著下降,但治疗费用并没有显著增加,差异均有统计学意义(P<0.05)。结论在急性重度精神类药物中毒的治疗中,洗胃往往不能获得良好收益,反而增加洗胃相关并发症的发生率,而早期的血液净化治疗能够显著改善患者预后,且不增加住院总费用,安全性较好,值得临床应用。Objective To investigate the value of emergency gastric lavage and blood purifi cation for acute severe psychiatric poisoning.Methods A total of 85 patients with acute severe psychotic drug poisoning admitted to the emergency department of Jiangsu Second Middle School Hospital from January 2017 to January 2023 were collected retrospectively.According to the treatment plan of the patients,they were divided into conservative treatment group,gastric lavage group,blood purifi cation group,gastric lavage and blood purifi cation group.Basic data of each group,incidence of complications related to gastric lavage and blood purifi cation,and prognosis related indicators of each group were collected.Results The 85 patients were 18 to 92 years,and there was no signifi cant diff erence in baseline data between groups(P>0.05).Compared with the conservative treatment and blood purification groups,the incidence of gastric lavage related complications in the gastric lavage and gastric lavage and blood purifi cation group signifi cantly increased(P<0.05),the incidence of falling pneumonia and cardiovascular and cerebrovascular accidents were lower in the conservative treatment and gastric lavage group(P<0.05).The prognosis related indicators in the blood purifi cation group and gastric lavage and blood purifi cation group decreased signifi cantly compared with the conservative treatment group and gastric lavage group,but the treatment cost did not increase signifi cantly,and the diff erence was statistically signifi cant(P<0.05).Conclusion In the treatment of acute severe psychiatric drug poisoning,gastric lavage often cannot get good benefi ts,but increased the complications of gastric lavage,and blood purifi cation treatment can signifi cantly improve patient outcomes without increasing the total hospitalization cost,and does not increase the total cost of hospital,safety is better,and it deserves being recommended in clinical recommendation.

关 键 词：急性中毒 精神类药物中毒 急诊洗胃 血液净化 

分 类 号：R459.7[医药卫生—急诊医学]