有机磷农药中毒机械通气相关危险因素分析.docVIP

精品论文 参考文献 有机磷农药中毒机械通气相关危险因素分析 梁兰玉 赵翔宇 殷安康 董世童 苗润丰 　　（扬州市第一人民医院急诊科 225003） 　　【摘要】 目的：回顾性分析急性有机磷农药中毒患者需机械通气的相关危险因素。方法：选取2002年1月至2012年12月间我院收治的有机磷农药中毒患者共186例为研究对象，依据纳入标准入选的患者129例，分为机械通气组和对照组，记录患者的性别，年龄，入院时血清胆碱酯酶活性（SCHE），入院时白细胞计数，血气分析，血乳酸（Lac）测定，CRP，心电图QTc值，进行APACHEⅡ评分（APACHEⅡS），NRS2002评分等，对两组进行分析。结果：与对照组相比，机械通气组平均年龄（52.72plusmn;19.73）,入院时血白细胞计数（19.3plusmn;10.8）、APACHEⅡs（17.4plusmn;5.8）高，入院时NRS2002评分ge;3患者比率高（42.3%），代谢性酸中毒（60.3%）及高乳酸血症（37.9%）发生率高。结论：年龄、入院时血白细胞计数、APACEⅡs，入院时酸中毒，高乳酸血症及患者存在营养风险可作为预测有机磷农药中毒的患者需要进行呼吸机辅助呼吸的危险因素。 　　【关键词】有机磷农药中毒；危险因素；机械通气；APACHⅡ评分；NRS2002 　　【中图分类号】R595 【文献标识码】A 【文章编号】2095-1752（2015）28-0160-02 　　Risk factors in patients requiring mechanical ventilation in acute Organophosphate posioning 　　 Liang Lanyu,Zhao Xiangyu,Yin Ankang,Dong Shitong,Miao Runfeng,Liu Han. 　　The emergency department of The first peoples hospital of yangzhou 　　【Abstract】Objective Analysis of risk factors in patients with early respiratory failure requiring mechanical ventilation in acute Organophosphate posioning(AOPP). Methods The clinical data of 186 patients with AOPP were collected during the period from January 1,2002 through December 30,2012 at the emergency department of The first peoples hospital of yangzhou.According to the rejection criteria,there were 129 patients available for analysis.The patetients were divided into acute respiratory failure group(A group) and control group(B group).The gender，age,QTC, APACHEⅡscore,blood parameters at admission,such as white blood cell count,，PH,Lac,CRP were compared betweem the two groups. Results Compared to control group，the average age（52.72plusmn;19.73） , white blood cell count at admission（19.3plusmn;10.8），APACHEⅡscore （17.4plusmn;5.8）the incidence rate of metabolic acidosis(60.3%) at admission and hyperlactacidemia(37.9%) ，NRS2002scorege;3（42.3%）at admission were significantly higher . Conclusion The age, white blood cell count at admission, APACHEⅡscore ，metabolic acidosis at