CAJ | 학술논문

目的探讨预见性救护支持对重度有机磷农药中毒气管插管患者预后的影响.方法将109例急性重度有机磷农药中毒气管插管患者按随机数字表法分为观察组55例和对照组54例.对照组患者遵医嘱予以洗胃与导泻,应用阿托品、氯解磷定及机械通气呼吸支持治疗常规护理,观察组在此基础上实施新式气管插管固定法,实施气管插管脱管报警装置及恒温湿化联合氧气驱动雾化为一体的预见性救护支持,观察比较两组救护效果.结果两组患者救治前呼吸、心率、血氧饱和度血气分析指标比较差异无统计学意义(P＞0.05),观察组救治后72 h呼吸、心率、血氧饱和度及血气分析指标与对照组比较差异均有统计学意义(t值分别为14.414,10.037,10.199,11.139,13.604,9.772；P＜0.05)；观察组患者机械通气时间、气管插管时间、监护时间及住院时间分别为(25.63±3.24)h,(32.17 ±3.50)h,(5.65±1.63)d,(8.52±2.13)d,对照组分别为(37.82±3.75)h,(43.64±3.83)h,(9.78±1.85)d,(13.79±2.17)d,两组比较差异均有统计学意义(t值分别为18.170,16.326,12.372,12.795；P ＜0.05).观察组非计划性拔管及并发症发生率为7.27％,明显低于对照组的29.63％,两组比较差异有统计学意义(x2 =9.090,P＜0.05),而观察组抢救成功率为96.36％,显著高于对照组的83.33％,两组比较差异有统计学意义(x2 =5.099,P＜0.05).结论 SAOPP气管插管患者启动预见性救护支持预案,提高了抢救成功率,减少了并发症,提高了患者救治效果,改善了患者预后.
목적 탐토예견성구호지지대중도유궤린농약중독기관삽관환자예후적영향.방법 장109례급성중도유궤린농약중독기관삽관환자안수궤수자표법분위관찰조55례화대조조54례.대조조환자준의촉여이세위여도사,응용아탁품、록해린정급궤계통기호흡지지치료상규호리,관찰조재차기출상실시신식기관삽관고정법,실시기관삽관탈관보경장치급항온습화연합양기구동무화위일체적예견성구호지지,관찰비교량조구호효과.결과 량조환자구치전호흡、심솔、혈양포화도혈기분석지표비교차이무통계학의의(P＞0.05),관찰조구치후72 h호흡、심솔、혈양포화도급혈기분석지표여대조조비교차이균유통계학의의(t치분별위14.414,10.037,10.199,11.139,13.604,9.772；P＜0.05)；관찰조환자궤계통기시간、기관삽관시간、감호시간급주원시간분별위(25.63±3.24)h,(32.17 ±3.50)h,(5.65±1.63)d,(8.52±2.13)d,대조조분별위(37.82±3.75)h,(43.64±3.83)h,(9.78±1.85)d,(13.79±2.17)d,량조비교차이균유통계학의의(t치분별위18.170,16.326,12.372,12.795；P ＜0.05).관찰조비계화성발관급병발증발생솔위7.27％,명현저우대조조적29.63％,량조비교차이유통계학의의(x2 =9.090,P＜0.05),이관찰조창구성공솔위96.36％,현저고우대조조적83.33％,량조비교차이유통계학의의(x2 =5.099,P＜0.05).결론 SAOPP기관삽관환자계동예견성구호지지예안,제고료창구성공솔,감소료병발증,제고료환자구치효과,개선료환자예후.
Objective To explore the effect of predictable aid support on the prognosis of patients with tracheal intubation for severe acute organophosphorus pesticide poisoning (SAOPP).Methods One hundred and nine patients with tracheal intubation for SAOPP were randomly divided into the treatment group (n =55)and control group (n =54).All patients in control group were treated with the gastric lavage and catharsis,accepted atropine and pralidoxime chloride and ventilatory support as prescribed.More predictability ambulance measures were applied to the treatment group such as reinforcement tracheal intubation,endotracheal intubation tube off alarm device and joint of thermostatic wetting with oxygen driving atomization.The therapy efficacy was compared between the two groups.Results Before treatment,breathing,heart rate,oxygen saturation and blood gas indexes had no differences (P ＞0.05) between the two groups.After a-72 h-treatment,the treatment group had significant differences on the above indicators compared with those of the control group (t =14.414,10.037,10.199,11.139,13.604,9.772,respectively; P ＜ 0.05).The duration of mechanical ventilation,tracheal intubation,monitoring and hospitalization were respectively (25.63 ± 3.24) h,(32.17 ± 3.50) h,(5.65 ±1.63) d,(8.52 ±2.13) d in the treatment group,and (37.82 ±3.75) h,(43.64 ±3.83) h,(9.78 ± 1.85) d,(13.79 ± 2.17) d in the control group,and the differences were statistically significant (t =18.170,16.326,12.372,12.795,respectively; P ＜ 0.05).The unplanned extubation and incidence of complication was 7.27％ in the treatment group,and 29.63％ in the control group,and the difference was statistically significant (x2 =9.090,P ＜ 0.05).The rescue success rate was 96.36％ in the treatment group,and 29.63％ in the control group,and the difference was statistically significant (x2 =5.099,P ＜ 0.05).Condusions The predictable aid support in endotracheal intubation can increase the success rate,enhance the efficacy,reduce complications and improve prognosis of SAOPP patients.