机械通气在救治急性毒鼠强中毒的应用  

The Apply of Mechanical Ventilation in Treatment of Acute Tetramine Intoxication(AT1)

作　　者：伍凌[1] 张希洲[1] 郑昌林[1] 张冬仿[1] 周文[1] 王青丽[1] 

机构地区：[1]湖北省宜昌市第一人民医院

出　　处：《临床急诊杂志》2003年第2期7-8,共2页Journal of Clinical Emergency

摘　　要：目的:观察机械通气在救治毒鼠强中毒患者时的应用效果。方法:对24例急性毒鼠强中毒患者均在确诊后,立即鼻气管插管建立人工气道,然后经口插胃管洗胃。如持续抽搐,在应用肌松剂持续静脉泵注的同时,立即给以机械通气进行呼吸支持,并动态监测机械通气前和机械通气后30分钟、1小时、12小时、24小时、48小时和脱机前动脉血气。通过统计学分析比较不同时期的动脉血气分析结果。同时统计其救治成功率。结果:所有患者在机械通气12小时后,低氧血症均有不同的程度的改善。所有患者在机械通气后48小时动脉血气各指标均恢复正常。与上机前比均有非常显著性差异(P<0.01)。结论:对于急性毒鼠强中毒患者的病因治疗虽至关重要,但控制持续抽搐和呼吸功能的支持和监测是预后的关键。因此,尽早建立人工气道,在出现持续抽搐时应用肌肉松弛剂的同时应用机械通气,能有效控制抽搐,有利于防治因持续抽搐所致低氧和急性呼吸功能不全引发的多脏器功能障碍综合征(MODS)。Purpose: To observe the effect of mechanical ventilation in treatment of acute tetramine intoxication(ATI). Methods: After confirming diagnosis of 24 ATI patients, build an artificial air tunnel through nasal airctay, then adopt gastric larvae by patting a pipe in through mouth. If the patient appeared convulsion, muscular relaxing agent might be given through an intravenous injection pump and at the same lime using artificial ventilator to help respiration. The arlerial blood gases was monitored before and at 30 1 hour 12 hours 24 hours and 48 hours and before ventilation ceased. Analysis of arterial blood gases at different period and sum up the ration of successful cases. Results: All patients diagnosed with low oxygen have been relieved at various level after mechanical ventilation for 12 hours, The complication of low oxygen improved obviously after mechanical ventilation for 48 hours. The difference between before and after using mechanical ventilation. ( P≤0.01). Conclusion: Although the treatment of ATI patient is important control of epileptic-form convulsion, and supportive treatment supervising to function of breath also helping of patient for recorery. Therefore building an artificial breath tunnel as soon as possible lo protect the patients against MODS caused by low oxygen.

关 键 词：机械通气 救治 急性毒鼠强中毒 应用 诊断 治疗 人工气道 鼻气管插管 

分 类 号：R595.4[医药卫生—内科学]