中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
8期
1173-1175,1176
,共4页
肠道营养%有机磷%农药%急性%中毒%治疗
腸道營養%有機燐%農藥%急性%中毒%治療
장도영양%유궤린%농약%급성%중독%치료
Enteral nutrition%Organophosphoras%Pesticide%Acute%Poisoning%Treatment
目的：探讨临床给予重度有机磷农药中毒患者采取早期肠内营养支持治疗对预后的影响。方法选取重度有机磷农药中毒患者56例，按随机数字表法分为A、B两组。两组均常规进行农药中毒抢救治疗。其中A组30例于48～72 h内使用营养泵开通肠内营养。B组则在常规抢救基础上，于72 h至5 d内开通肠内营养。比较两组治疗过程中意识恢复时间，胆碱酯酶（CHE）恢复至正常60％的时间，中间综合征发生率，腹痛、腹胀、呕吐、返流、腹泻等胃肠道并发症发生率，呼吸机相关性肺炎（VAP）发生率，多脏器功能障碍综合征（MODS）发生率。结果 A组意识恢复时间（3．6±0．8）d，较B组的（4．1±0．6）d 显著缩短（t＝2.612，P＜0．01）；A组胆碱酯酶恢复正常60％时间为（5．5±1．3）d，较B组的（6．3±1．1）d缩短（t＝2．464， P＜0．05）；A组中间综合症发生率（3．3％）、VAP发生率（13．3％）均显著低于B组（38．5％、46．2％）（χ2＝4.691，P＜0．05；χ2＝7．352，P＜0．01）；A组MODS 发生率（13．3％）较B组（38．5％）减少（χ2＝4．691，P＜0.05）；A组住ICU时间（8．0±1．2）d，较B组的（12．0±2．4）d显著缩短（t＝7．705，P＜0．01）。两组胃肠道反应差异无统计学意义（P＞0．05）。结论对重度有机磷农药中毒患者使用营养泵早期开通肠内营养是安全有效的，值得临床借鉴及推广。
目的：探討臨床給予重度有機燐農藥中毒患者採取早期腸內營養支持治療對預後的影響。方法選取重度有機燐農藥中毒患者56例，按隨機數字錶法分為A、B兩組。兩組均常規進行農藥中毒搶救治療。其中A組30例于48～72 h內使用營養泵開通腸內營養。B組則在常規搶救基礎上，于72 h至5 d內開通腸內營養。比較兩組治療過程中意識恢複時間，膽堿酯酶（CHE）恢複至正常60％的時間，中間綜閤徵髮生率，腹痛、腹脹、嘔吐、返流、腹瀉等胃腸道併髮癥髮生率，呼吸機相關性肺炎（VAP）髮生率，多髒器功能障礙綜閤徵（MODS）髮生率。結果 A組意識恢複時間（3．6±0．8）d，較B組的（4．1±0．6）d 顯著縮短（t＝2.612，P＜0．01）；A組膽堿酯酶恢複正常60％時間為（5．5±1．3）d，較B組的（6．3±1．1）d縮短（t＝2．464， P＜0．05）；A組中間綜閤癥髮生率（3．3％）、VAP髮生率（13．3％）均顯著低于B組（38．5％、46．2％）（χ2＝4.691，P＜0．05；χ2＝7．352，P＜0．01）；A組MODS 髮生率（13．3％）較B組（38．5％）減少（χ2＝4．691，P＜0.05）；A組住ICU時間（8．0±1．2）d，較B組的（12．0±2．4）d顯著縮短（t＝7．705，P＜0．01）。兩組胃腸道反應差異無統計學意義（P＞0．05）。結論對重度有機燐農藥中毒患者使用營養泵早期開通腸內營養是安全有效的，值得臨床藉鑒及推廣。
목적：탐토림상급여중도유궤린농약중독환자채취조기장내영양지지치료대예후적영향。방법선취중도유궤린농약중독환자56례，안수궤수자표법분위A、B량조。량조균상규진행농약중독창구치료。기중A조30례우48～72 h내사용영양빙개통장내영양。B조칙재상규창구기출상，우72 h지5 d내개통장내영양。비교량조치료과정중의식회복시간，담감지매（CHE）회복지정상60％적시간，중간종합정발생솔，복통、복창、구토、반류、복사등위장도병발증발생솔，호흡궤상관성폐염（VAP）발생솔，다장기공능장애종합정（MODS）발생솔。결과 A조의식회복시간（3．6±0．8）d，교B조적（4．1±0．6）d 현저축단（t＝2.612，P＜0．01）；A조담감지매회복정상60％시간위（5．5±1．3）d，교B조적（6．3±1．1）d축단（t＝2．464， P＜0．05）；A조중간종합증발생솔（3．3％）、VAP발생솔（13．3％）균현저저우B조（38．5％、46．2％）（χ2＝4.691，P＜0．05；χ2＝7．352，P＜0．01）；A조MODS 발생솔（13．3％）교B조（38．5％）감소（χ2＝4．691，P＜0.05）；A조주ICU시간（8．0±1．2）d，교B조적（12．0±2．4）d현저축단（t＝7．705，P＜0．01）。량조위장도반응차이무통계학의의（P＞0．05）。결론대중도유궤린농약중독환자사용영양빙조기개통장내영양시안전유효적，치득림상차감급추엄。
Objective To explore the clinical curative effect of early enteral nutritional support for acute se-vere organophosphorus pesticide poisoning.Methods 56 cases with acute severe organophosphorus pesticide poison-ing were selected and divided into group A and group B in accordance with the random number table.Both groups were given conventional emergency treatment.Enteral nutrition support with nutrition pump was applied for 30 cases of group A in 48 -72hours,while group B in 72h -5d.The time of consciousness recovery,CHE increase to normal 60%,the incidence rate of intermediate syndrome,gastrointestinal complications of abdominal pain,abdominal disten-sion,vomiting,reflux,diarrhea,VAP,MODS of the two groups of patients were compared.Results The time of con-sciousness recovery (3.6 ±0.8)d in group A was lower than that of group B(4.1 ±0.6)d (t=2.612,P<0.01), the CHE increase to normal 60%(5.5 ±1.3)d in group A was lower than that of group B(6.3 ±1.1)d(t=2.464, P<0.05),the incidence rate of intermediate syndrome(3.3%)in group A was lower than that of group B(38.5%) (χ2 =4.691,P<0.05),the VAP of 13.3% in group A was lower than that of group B(46.2%)(χ2 =7.352,P<0.01),the MODS of 13.3% in group A was lower than 38.5% of group B(χ2 =4.691,P<0.05),the duration in ICU of (8.0 ±1.2)d in group A was lower than (12.0 ±2.4)d of group B(t=7.705,P<0.01).There was no sig-nificant difference of gastrointestinal complications between the two groups (P >0.05 ).There was no significant difference of gastrointestinal complications between the two groups (P>0.05).Conclusion Early enteral nutritional support is effective and safe for acute severe organophosphorus pesticide poisoning and worthy of promotion.
