有创通气在重度急性有机磷中毒中的应用
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摘要
目的观察有创机械通气在急诊抢救重度有机磷中毒中的应用价值。方法 2010年1月—2015年12月到我院急诊就诊的重度有机磷中毒所致呼吸衰竭患者46例为对照组,来院后即给予一般抢救措施。2016年1月—2017年10月到急诊就诊的重度有机磷中毒所致呼吸衰竭患者为观察组,给予一般救治措施,并在出现呼吸不规则、Sp O2<95%时进行有创机械通气,对两组患者苏醒时间、胆碱酯酶恢复时间、住院天数、痊愈率、死亡率等进行比较。结果观察组患者苏醒时间、胆碱酯酶恢复时间均较对照组明显要短(P <0.05);观察组痊愈率较对照组明显要高(P <0.05),死亡率较对照组明显要低(P <0.05)。结论通过及时有效的对急性重度有机磷中毒患者实行有创机械通气,缩短了患者的苏醒时间,提高了治愈率,降低了患者的住院天数及死亡率。
Objective To observe the application value of invasive mechanical ventilation in emergency rescue of severe organophosphorus poisoning. Methods 46 patients with severe organophosphorus poisoning who came to our hospital for emergency treatment from January 2010 to December 2015 were selected as the control group. They were given general rescue measures immediately after coming to our hospital. Patients with severe organophosphorus poisoning who visited the emergency department from January 2016 to October 2017 were in the observation group. They were given general treatment measures and were given invasive mechanical ventilation when respiratory irregularities and Sp O2 < 95% occurred. The recovery time, recovery time of cholinesterase, hospitalization days, recovery rate and mortality of the two groups were compared. Results The awakening time and recovery time of cholinesterase in the observation group were significantly shorter than those in the control group(P < 0.05). The recovery rate of the observation group was significantly higher than that of the control group(P < 0.05). The mortality rate was significantly lower than that of the control group(P < 0.05). Conclusion Through timely and effective invasive mechanical ventilation in patients with acute severe organophosphorus poisoning, the recovery time of patients was shortened, the cure rate was increased, and the hospitalization days and mortality were reduced.
Objective To observe the application value of invasive mechanical ventilation in emergency rescue of severe organophosphorus poisoning. Methods 46 patients with severe organophosphorus poisoning who came to our hospital for emergency treatment from January 2010 to December 2015 were selected as the control group. They were given general rescue measures immediately after coming to our hospital. Patients with severe organophosphorus poisoning who visited the emergency department from January 2016 to October 2017 were in the observation group. They were given general treatment measures and were given invasive mechanical ventilation when respiratory irregularities and Sp O2 < 95% occurred. The recovery time, recovery time of cholinesterase, hospitalization days, recovery rate and mortality of the two groups were compared. Results The awakening time and recovery time of cholinesterase in the observation group were significantly shorter than those in the control group(P < 0.05). The recovery rate of the observation group was significantly higher than that of the control group(P < 0.05). The mortality rate was significantly lower than that of the control group(P < 0.05). Conclusion Through timely and effective invasive mechanical ventilation in patients with acute severe organophosphorus poisoning, the recovery time of patients was shortened, the cure rate was increased, and the hospitalization days and mortality were reduced.
引文
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[2]陆翠玲,唐晟,刘京涛,等.急性重度有机磷农药中毒行机械通气患者人工气道的护理[J].现代临床护理,2015,14(9):20-23.
[3]雷金花,黄菊敏,吴晓云.早期消化道毒物清除的集束化护理在急性重度有机磷中毒的应用[J].安徽医药,2013,17(4):712-713.
[4]吴兵,刘晓伟,刘志.氯解磷定不同用药方案对急性重度有机磷中毒的疗效比较[J].中国医科大学学报,2017,46(10):949-951.
[5]任冬,许凌峰,石俊生.长托宁联合阿托品治疗急性重度有机磷中毒的临床应用[J].中国急救医学,2016,36(z1):130-131.
[6]高玉莲.集束化护理对急性重度有机磷中毒患者的影响[J].齐鲁护理杂志,2017,23(3):89-90.
[7]朱聪.阿托品联合长托宁在急性重度有机磷中毒抢救中的疗效观察[J].首都食品与医药,2018,25(7):36..
[8]吴垣奎.长托宁治疗42例急性重度有机磷中毒的临床效果观察[J].黑龙江医学,2016,40(10):928-929.
[9]张先江,卢博,孙胜利,等.血液灌流治疗急性重度有机磷中毒的研究[J].中国热带医学,2014,14(10):1232-1234.
[10]刘勇.呼吸机治疗重症急性有机磷农药中毒呼吸衰竭的疗效观察[J].临床医药文献杂志,2015,2(36):7400-7401.
[11]杨菊霞.机械通气治疗急性重度有机磷中毒并呼吸衰竭的护理体会[J].河南外科学杂志,2013,19(4):157-158.
[12]杨丽华.综合护理对血液灌流治疗急性重度有机磷中毒患者的效果分析[J].临床医学研究与实践,2017,2(21):151-152.