小潮气量肺保护通气治疗急性有机磷农药中毒所致呼吸衰竭的临床效果分析  

Analysis of Clinical Effect of Low Tidal Volume Lung Protective Ventilation on Respiratory Failure Caused By Acute Organophosphorus Pesticide Poisoning

作　　者：刘燕华 LIU Yanhua(Department of Emergency,Wuping County Hospital in Longyan City,Longyan 364300,Fujian,China)

机构地区：[1]龙岩市武平县医院急诊科,福建龙岩364300

出　　处：《中外医疗》2024年第18期29-33,共5页China & Foreign Medical Treatment

摘　　要：目的探讨小潮气量肺保护通气治疗急性有机磷农药中毒(Acute Organophosphorus Pesticide Poisoning,AOPP)所致呼吸衰竭患者的临床疗效。方法回顾性选取2021年2月—2023年9月龙岩市武平县医院收治的60例AOPP所致呼吸衰竭患者的临床资料,依据不同治疗方法分为两组,每组30例。对照组采用常规机械通气治疗,观察组采用小潮气量肺保护通气治疗。比较两组患者血气分析指标、康复效果、氧化应激水平及不良反应发生情况。结果治疗后,观察组康复时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者血气分析指标、氧化应激水平比较,差异无统计学意义(P均>0.05);治疗后,观察组动脉血氧分压、超氧化物歧化酶、血氧饱和度、定谷胱甘肽水平高于对照组,动脉血二氧化碳分压、丙二醛指标低于对照组,差异有统计学意义(P均<0.05)。观察组不良反应发生率为6.67%,与对照组的16.67%相比,差异无统计学意义(χ^(2)=0.647,P=0.421)。结论小潮气量肺保护通气治疗急性有机磷农药中毒所致呼吸衰竭患者可有效缓解氧化应激损伤,调节血气分析指标水平,促进患者康复。Objective To explore the clinical effect of lung protective ventilation with low tidal volume on patients with respiratory failure caused by acute organophosphorus pesticide poisoning(AOPP).Methods The clinical data of 60 patients with AOPP-induced respiratory failure treated in Wuping County Hospital in Longyan City from February 2021 to September 2023 were retrospectively selected and divided into two groups according to different treatment methods,with 30 cases in each group.The control group was treated with conventional mechanical ventilation,and the observation group was treated with low tidal volume lung protective ventilation.The indexes of blood gas analysis,re-habilitation effect,oxidative stress and safety were compared between the two groups.Results After treatment,the re-covery time of observation group was shorter than that of control group,the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in blood gas analysis index and oxidative stress level between two groups(both P>0.05);after treatment,the arterial blood oxygen partial pressure,superoxide dis-mutase,oxygen saturation and fixed glutathione level in observation group were higher than those in control group,while the arterial blood carbon dioxide partial pressure and malondialdehyde indexes were lower than those in control group,the differences were statistically significant(all P<0.05).The incidence of adverse reactions in the observation group was 6.67%,compared with 16.67%in the control group,the difference was not statistically significant(χ^(2)=0.647,P=0.421).Conclusion Low tidal volume lung protective ventilation in the treatment of acute organophosphorus pesticide poisoning caused by respiratory failure patients can effectively alleviate oxidative stress damage,adjust the level of blood gas analysis index,and promote the recovery of patients.

关 键 词：急性有机磷农药中毒 呼吸衰竭 小潮气量肺保护通气 常规机械通气 血气分析 氧化应激 

分 类 号：R563.8[医药卫生—呼吸系统]