中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
Chinese Journal of Industrial Hygiene and Occupational Diseases
2015年
9期
693-694
,共2页
任爱农%任思庆%菅向东%张青
任愛農%任思慶%菅嚮東%張青
임애농%임사경%관향동%장청
百草枯%中毒%肺纤维化%碳酸氢钠
百草枯%中毒%肺纖維化%碳痠氫鈉
백초고%중독%폐섬유화%탄산경납
Paraquat%Poisoning%Pulmonary fibrosis%Sodium bicarbonate
目的 观察急性百草枯中毒患者碳酸氢钠洗胃、雾化吸入与静脉注射三联法预防肺渗出与纤维化的效果.方法 收集来院治疗的38例百草枯中毒患者为观察组,用质量浓度为1.5％的碳酸氢钠溶液洗胃,采用质量浓度为5％碳酸氢钠溶液10～15 ml雾化吸入2次/d;并5％碳酸氢钠溶液100ml快速静脉滴注,2次/d,连续应用5～7 d.抽取既往资料完整未用碳酸氢钠患者38例作对照组.比较两组患者肺部HRCT评分及治疗后7d的肝肾功能指标.结果 对照组百草枯中毒患者3、7、30 d肺HRCT平均评分达到2.87.3.12、2.13,HRCT示呈现出磨玻璃影、网格影和蜂窝影等渗出及纤维化征象.观察组患者3、7、30d肺HRCT平均评分分别为1.95、2.20、1.67,HRCT示肺渗出及纤维化征象显著减少,两组HRCT评分比较,差异有统计学意义(P＜0.01).与对照组比较,观察组百草枯中毒患者血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)活力明显降低,血清尿素氮(BUN)、肌酐(Cr)水平明显降低,差异有统计学意义(P＜0.01).结论 碳酸氢钠洗胃、雾化吸入与静脉注射联合应用可使百草枯中毒患者肺渗出及纤维化的发生程度减轻、范围减少,对肝肾功能有明显的保护作用.
目的 觀察急性百草枯中毒患者碳痠氫鈉洗胃、霧化吸入與靜脈註射三聯法預防肺滲齣與纖維化的效果.方法 收集來院治療的38例百草枯中毒患者為觀察組,用質量濃度為1.5％的碳痠氫鈉溶液洗胃,採用質量濃度為5％碳痠氫鈉溶液10～15 ml霧化吸入2次/d;併5％碳痠氫鈉溶液100ml快速靜脈滴註,2次/d,連續應用5～7 d.抽取既往資料完整未用碳痠氫鈉患者38例作對照組.比較兩組患者肺部HRCT評分及治療後7d的肝腎功能指標.結果 對照組百草枯中毒患者3、7、30 d肺HRCT平均評分達到2.87.3.12、2.13,HRCT示呈現齣磨玻璃影、網格影和蜂窩影等滲齣及纖維化徵象.觀察組患者3、7、30d肺HRCT平均評分分彆為1.95、2.20、1.67,HRCT示肺滲齣及纖維化徵象顯著減少,兩組HRCT評分比較,差異有統計學意義(P＜0.01).與對照組比較,觀察組百草枯中毒患者血清丙氨痠轉氨酶(ALT)、天鼕氨痠轉氨酶(AST)活力明顯降低,血清尿素氮(BUN)、肌酐(Cr)水平明顯降低,差異有統計學意義(P＜0.01).結論 碳痠氫鈉洗胃、霧化吸入與靜脈註射聯閤應用可使百草枯中毒患者肺滲齣及纖維化的髮生程度減輕、範圍減少,對肝腎功能有明顯的保護作用.
목적 관찰급성백초고중독환자탄산경납세위、무화흡입여정맥주사삼련법예방폐삼출여섬유화적효과.방법 수집래원치료적38례백초고중독환자위관찰조,용질량농도위1.5％적탄산경납용액세위,채용질량농도위5％탄산경납용액10～15 ml무화흡입2차/d;병5％탄산경납용액100ml쾌속정맥적주,2차/d,련속응용5～7 d.추취기왕자료완정미용탄산경납환자38례작대조조.비교량조환자폐부HRCT평분급치료후7d적간신공능지표.결과 대조조백초고중독환자3、7、30 d폐HRCT평균평분체도2.87.3.12、2.13,HRCT시정현출마파리영、망격영화봉와영등삼출급섬유화정상.관찰조환자3、7、30d폐HRCT평균평분분별위1.95、2.20、1.67,HRCT시폐삼출급섬유화정상현저감소,량조HRCT평분비교,차이유통계학의의(P＜0.01).여대조조비교,관찰조백초고중독환자혈청병안산전안매(ALT)、천동안산전안매(AST)활력명현강저,혈청뇨소담(BUN)、기항(Cr)수평명현강저,차이유통계학의의(P＜0.01).결론 탄산경납세위、무화흡입여정맥주사연합응용가사백초고중독환자폐삼출급섬유화적발생정도감경、범위감소,대간신공능유명현적보호작용.
Objective To observe the prevention effects of patients with lung exudation and pulmonary fibrosis induced by paraquat poisoning in sodium bicarbonate (SB) with gastric lavage,atomization inhalation and intravenous injection.Methods To collect 38 patients with paraquat poisoning in hospital,after poison immediately with gastric lavage of 1.5％ SB,and atomization inhalation of 5％SB 10～15 ml twice daily and intravenous injection of 5％ SB twice a day,continuous application of 5～7 days.and the HRCT score and liver and kidney function was performed on patients with lung after treatment.And the extraction of 38 SB patients with previously untreated with SB for comparison.Results Lung HRCT average score in 72 h,7 d,30 d on patients with paraquat poisoning untreated with SB reached 2.87,3.12,2.13,HRCT display shows that the appearance of the wear glass shadow,grid shadow,honeycomb shadow,and other signs of fibrosis.Average HRCT reached 1.95,2.20,1.67 on patients treated with SB,signs of lung exudation and fibrosis was significantly reduced,compare two groups,there was statistically significance (P＜0.01).And compared to the control group,activity of serum alanine aminotransferase (ALT) and aspartic acid transaminase (AST) decreased significantly in group of paraquat poisoning with triple application of SB,the level of serum urea nitrogen (BUN) and creatinine (Cr) significantly decreased,the difference is statistically significant (P＜0.01).Conclusion The triple application of SB can reduced the pulmonary fibrosis and effusion induced by paraquat poisoning,and protective effect on the function of liver and kidney is obvious,suggesting that the method for treatment of paraquat poisoning,prevention of paraquat lung and improve survival rate has the exact effect.
