CAJ | 학술논문

目的观察鼻饲大黄水溶液、芒硝敷脐导泻救治重度急性有机磷农药中毒(AOPP)患者的效果.方法采用回顾性分析方法,选择80例重度AOPP患者,按治疗方法不同分为两组,每组40例.所有患者给予彻底洗胃、正确使用胆碱酯酶复能剂及阿托品等综合治疗,在此基础上,一组鼻饲大黄水溶液200 ml、芒硝100 g敷脐治疗(大黄芒硝组),另一组鼻饲20％甘露醇200 ml作为对照(甘露醇组).观察两组患者首次排便时间、导泻期间排便次数、胆碱酯酶(ChE)活性恢复正常时间、阿托品化时间、阿托品化用量、阿托品总用量、不良反应发生率、住院时间,并进行统计学分析.结果大黄芒硝组各指标改善情况均好于甘露醇组[首次排便时间(min):134.13±31.31比154.35±34.78,导泻期间排便次数(次/d):2.60±0.81比2.14±0.63,ChE活性恢复正常时间(d):9.65±1.42比10.66±1.74,阿托品化时间(h):3.00±0.73比3.56±1.02,阿托品化用量(mg):51.43±7.03比57.65±7.74,阿托品总用量(mg):229.78±28.96比248.41±31.45,不良反应发生率:腹痛0比17.5％、腹胀0比20.0％,住院时间(d):10.43±1.68比11.59±2.12],差异均有统计学意义(均P＜0.01).结论联用大黄水溶液和芒硝敷脐导泻治疗重度AOPP患者,能及时清除肠内毒物,减少不良反应,缩短住院时间.
목적 관찰비사대황수용액、망초부제도사구치중도급성유궤린농약중독(AOPP)환자적효과.방법 채용회고성분석방법,선택80례중도AOPP환자,안치료방법불동분위량조,매조40례.소유환자급여철저세위、정학사용담감지매복능제급아탁품등종합치료,재차기출상,일조비사대황수용액200 ml、망초100 g부제치료(대황망초조),령일조비사20％감로순200 ml작위대조(감로순조).관찰량조환자수차배편시간、도사기간배편차수、담감지매(ChE)활성회복정상시간、아탁품화시간、아탁품화용량、아탁품총용량、불량반응발생솔、주원시간,병진행통계학분석.결과 대황망초조각지표개선정황균호우감로순조[수차배편시간(min):134.13±31.31비154.35±34.78,도사기간배편차수(차/d):2.60±0.81비2.14±0.63,ChE활성회복정상시간(d):9.65±1.42비10.66±1.74,아탁품화시간(h):3.00±0.73비3.56±1.02,아탁품화용량(mg):51.43±7.03비57.65±7.74,아탁품총용량(mg):229.78±28.96비248.41±31.45,불량반응발생솔:복통0비17.5％、복창0비20.0％,주원시간(d):10.43±1.68비11.59±2.12],차이균유통계학의의(균P＜0.01).결론 련용대황수용액화망초부제도사치료중도AOPP환자,능급시청제장내독물,감소불량반응,축단주원시간.
Objective To investigate the effect of nasal tube feeding of rhubarb solution and umbilical compress of Glauber's salt for purgation in the treatment of patients with severe acute organophosphorus pesticide poisoning (AOPP).Methods A retrospective study was conducted.Eighty patients with severe AOPP were dividedinto two groups according to different treatment,with 40 patients in each group.A thorough gastric lavage was done,followed by cholinesterase complex agent and atropine were given for all the patients.On the base of this treatment,one group of patients were given nasogastric feeding of rhubarb solution (200 ml) and Glauber's salt solution ( 100 g) for umbilical compress (rhubarb plus Glauher group),and another group of patients were fed with 20％ mannitol (200 ml)as a control group (mannitol group).The time of first defecation,number of passing stools,the time of normalization of cholinesterase (ChE) activity,time of atropinization,dosage of atropinization,and total amount of atropine given,incidence of adverse reactions,and hospital stay in two groups were observed,a statistical analysis of the data was conducted.Results In rhubarb plus Glauber group,all the conditions were improved better than those of mannitol group [first defecation time (minutes):134.13 ± 31.31 vs.154.35 ± 34.78,the number of stools (times/d):2.60 ±0.81 vs.2.14 ± 0.63,time of ChE activity returned to normal (days):9.65 ± 1.42 vs.10.66 ± 1.74,atropinization time ( hours ):3.00 ± 0.73 vs.3.56 ± 1.02,dosage of atropinization (mg):51.43 ± 7.03 vs.57.65 ± 7.74,the total amount of atropine given (mg):229.78 ± 28.96 vs.248.41 ± 31.45,the incidence of adverse reactions:abdominal pain 0 vs.17.5％,abdominal distention 0 vs.20.0％,hospital stay (days):10.43 ± 1.68 vs.11.59 ± 2.121,and all the differences were statistically significant (all P＜0.01).Conclusion Combination usage with aqueous rhubarb solution and Glauber's salt in AOPP patients could yield quick clearance of toxin,reduced adverse effects,and lower length of hospital stay.