急救重度有机磷中毒伴呼吸衰竭的急救对策及预后分析.docVIP

急救重度有机磷中毒伴呼吸衰竭的急救对策及预后分析 　　[摘要] 目的 分析研究重度有机磷中毒伴呼吸衰竭患者的急救方法，分析解磷定对患者的治疗价值。方法 选择2010年7月―2013年6月该院重度有机磷中毒伴呼吸衰竭的患者58例为研究对象，随机分为两组。对照组使用一般治疗方法，实验组使用解磷定治疗，对比观察两组治疗后的效果。结果 实验组患者带机时间短，气管切开率低，患者3 d内脱机率高，两组对比差异有统计学意义（P0.05）；实验组病死率低于对照组患者（P0.05）。结论 对重症有机磷中毒伴呼吸衰竭患者给予解磷定急救治疗可以提高救治效果，患者撤机快，呼吸衰竭时间缩短，值得应用。 　　[关键词] 有机磷中毒；呼吸衰竭；急救；解磷定 　　[中图分类号] R59 [文献标识码] A [文章编号] 1674-0742（2014）04（b）-0016-02 　　[Abstract] Objective To analyze the first-aid method for patients with severe organophosphate poisoning and respiratory failure， and the therapeutic value of pralidoxime for the patients. Methods 58 cases of patients with severe organophosphate poisoning and respiratory failure admitted in our hospital from July， 2010 to June， 2013 were selected as the subjects， and they were randomly divided into two groups. The control group was treated with the general treatment method， and the experimental group was treated with pralidoxime. The treatment effect of two groups was observed and compared. Results The patients in the experimental group had shorter time with a ventilator， lower rate of tracheotomy， higher withdrawal probability of ventilator within 3d， the differences between two groups were statistically significant （P0.05）； the mortality of the experimental group was lower than that of the control group （P0.05）. Conclusion Pralidoxime given to the patients with severe organophosphate poisoning and respiratory failure for first-aid treatment can improve the treatment effect； patients need shorter time of needing for ventilation with shorter respiratory failure time， which is worthy of application. 　　[Key words] Organophosphate poisoning； Respiratory failure； First aid； Pralidoxime 　　重症有机磷中毒患者的主要机制是由于有机磷农药中磷酰基与乙酰胆碱酯酶相结合[1]，导致机体失去水解乙酰胆碱的能力，对胆碱受体有过多的激动，导致外周胆碱能效应出现，形成中毒的症状[2]。且严重的患者还会容易发生呼吸衰竭，并会导致患者死亡。为了更好地对重度有机磷中毒伴呼吸衰竭患者进行急救，现分析2010年7月―2013年6月间该院收治的58例重度有机磷中毒伴呼吸衰竭患者的临床资料，报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择该院重度有机磷中毒伴呼吸衰竭的患者58例为研究对象。随机将患者分为两组。对照组29例，男13例，女16例，年龄跨度在22～71岁之间，平均为（39.98±12.38）