蚌埠医学院学报
蚌埠醫學院學報
방부의학원학보
ACTA ACADEMIAE MEDICINAE BENGBU
2015年
8期
1008-1010,1011
,共4页
农药中毒%有机磷农药%消化道%毒物清除术
農藥中毒%有機燐農藥%消化道%毒物清除術
농약중독%유궤린농약%소화도%독물청제술
pesticide poisoning%organophosphorus pesticide%digestive tract%poison removal
目的：：观察综合消化道毒物清除术在重度有机磷农药中毒( AOPP)中的临床效果。方法：重度AOPP患者56例随机分为2组，对照组给予常规洗胃、阿托品、抗感染、吸氧等综合治疗，观察组在对照组基础上行综合消化道毒物清除术，对2组治疗一般情况、血清学指标和转归结果进行比较。结果：观察组患者的住院时间、住院费用、清洁肠道时间、阿托品用量、氯磷定用量、阿托品化时间和胆碱酯酶恢复正常时间均明显少于对照组(P<0.01)。治疗后2组患者的白细胞、肌酸激酶、乳酸脱氢酶、天冬氨酸氨基转移酶、血清抵抗素和内脂素水平较治疗前显著降低(P<0.01)；且观察组患者白细胞、肌酸激酶、乳酸脱氢酶、天冬氨酸氨基转移酶、血清抵抗素和内脂素水平均较对照组显著降低(P<0.01)。观察组患者病死率显著低于对照组(P<0.01)；观察组的严重并发症发生率显著低于对照组(P<0.01)。结论：综合消化道毒物清除术可清除毒物，恢复胆碱酯酶水平，提高治愈率，减少并发症，在重度AOPP治疗中值得应用。
目的：：觀察綜閤消化道毒物清除術在重度有機燐農藥中毒( AOPP)中的臨床效果。方法：重度AOPP患者56例隨機分為2組，對照組給予常規洗胃、阿託品、抗感染、吸氧等綜閤治療，觀察組在對照組基礎上行綜閤消化道毒物清除術，對2組治療一般情況、血清學指標和轉歸結果進行比較。結果：觀察組患者的住院時間、住院費用、清潔腸道時間、阿託品用量、氯燐定用量、阿託品化時間和膽堿酯酶恢複正常時間均明顯少于對照組(P<0.01)。治療後2組患者的白細胞、肌痠激酶、乳痠脫氫酶、天鼕氨痠氨基轉移酶、血清牴抗素和內脂素水平較治療前顯著降低(P<0.01)；且觀察組患者白細胞、肌痠激酶、乳痠脫氫酶、天鼕氨痠氨基轉移酶、血清牴抗素和內脂素水平均較對照組顯著降低(P<0.01)。觀察組患者病死率顯著低于對照組(P<0.01)；觀察組的嚴重併髮癥髮生率顯著低于對照組(P<0.01)。結論：綜閤消化道毒物清除術可清除毒物，恢複膽堿酯酶水平，提高治愈率，減少併髮癥，在重度AOPP治療中值得應用。
목적：：관찰종합소화도독물청제술재중도유궤린농약중독( AOPP)중적림상효과。방법：중도AOPP환자56례수궤분위2조，대조조급여상규세위、아탁품、항감염、흡양등종합치료，관찰조재대조조기출상행종합소화도독물청제술，대2조치료일반정황、혈청학지표화전귀결과진행비교。결과：관찰조환자적주원시간、주원비용、청길장도시간、아탁품용량、록린정용량、아탁품화시간화담감지매회복정상시간균명현소우대조조(P<0.01)。치료후2조환자적백세포、기산격매、유산탈경매、천동안산안기전이매、혈청저항소화내지소수평교치료전현저강저(P<0.01)；차관찰조환자백세포、기산격매、유산탈경매、천동안산안기전이매、혈청저항소화내지소수평균교대조조현저강저(P<0.01)。관찰조환자병사솔현저저우대조조(P<0.01)；관찰조적엄중병발증발생솔현저저우대조조(P<0.01)。결론：종합소화도독물청제술가청제독물，회복담감지매수평，제고치유솔，감소병발증，재중도AOPP치료중치득응용。
Objective:To observe the clinical effects of the application of comprehensive digestive tract poison removal in patients with severe organophosphorus pesticide poisoning( AOPP) . Methods:Fifty-six severe AOPP patients were randomly divided into the control group and observation group. The control group and observation group were treated with the conventional gastric lavage,atropine,anti-infection and oxygen therapy, and comprehensive digestive tract poison removal based on the control group, respectively. The general condition,serological indexes and outcome between two groups were compared. Results:The hospitalization time,hospitalization cost, cleaning intestinal time,atropine dosage,pralidoxime chloride dosage,atropinization time and cholinesterase recovery time in observation group were significantly less than those in control group(P<0. 01). After treatment,the levels of the white blood cells,creatine kinase, lactate dehydrogenase,aspartate transaminase,serum resistin and visfatin in two groups decreased significantly(P <0. 01),and the decreasing degree of whose in observation group were significantly higher than those in control group(P<0. 01). The mortality and incidence of severe complications in observation group were significantly lower than those in control group(P<0. 01). Conclusions:The comprehensive digestive tract poison removal can clean poison, recover cholinesterase level, improve cure rate and reduce complications,which is worthy of clinical use during the treatment of severe AOPP.
