急性有机磷农药中毒并发上消化道出血临床研究.docVIP

急性有机磷农药中毒并发上消化道出血临床研究 　　【摘要】 目的 探讨急性有机磷农药中毒并发上消化道出血患者的临床情况。方法 186例急性有机磷农药中毒患者作为研究对象， 根据患者的临床症状进行分组：93例出现上消化道出血的患者作为观察组， 93例未出现上消化道出血的患者作为对照组， 记录观察组患者上消化道出血发生情况， 比较两组患者血糖浓度、急性生理学及慢性健康状况评分Ⅱ（APACHEⅡ）、血清胆碱酯酶水平。结果 观察组患者消化道出血108次， 其中毒物损伤胃黏膜71次， 洗胃损伤20次， 应激性溃疡17次。出现上消化道出血的时间为0.50～90.00 h， 平均时间（11.87±29.68）h。两组患者的血糖浓度比较， 差异无统计学意义（P0.05）；观察组患者入院24 h APACHEⅡ评分为（16.52±6.20）分高于对照组的（10.03±5.91）分， 差异有统计学意义（P0.05）；观察组患者血清胆碱酯酶水平为（323.62±109.13）U/L低于对照组的（420.32±122.75）U/L， 差异有统计学意义（P0.05）。结论 通过APACHEⅡ评分以及血清胆碱酯酶可以有效判断急性有机磷农药中毒患者上消化道出血的具体情况， 值得在临床推广应用。 　　【关键词】 急性有机磷农药中毒；上消化道出血；临床研究 　　DOI：10.14163/j.cnki.11-5547/r.2017.18.006 　　【Abstract】 Objective To explore the clinical situation of acute organophosphorus pesticide poisoning complicated with upper gastrointestinal bleeding patients. Methods A total of 186 acute organophosphorus pesticide poisoning patients as study subjects， and grouping was based on their clinical symptoms. There were 93 patients with upper gastrointestinal bleeding patients as observation group， and 93 patients without upper gastrointestinal bleeding patients as control group. Record was made on occurrence of upper gastrointestinal bleeding in observation group， and comparison were made on blood glucose concentration， acute physiology and chronic health score II （APACHE II） and serum cholinesterase level in two groups. Results The observation group had 108 times of gastrointestinal bleeding， including 71 times of toxic damage to gastric mucosa， 20 times of gastric lavage injury， and 17 times of stress ulcer. Time of upper gastrointestinal bleeding was 0.50～90.00 h， with average time as （11.87±29.68） h. Both groups had no statistically significant difference in blood glucose concentration （P0.05）. The observation group had higher APACHEⅡ score after 24 h of admission as （16.52±6.20） points than （10.03±5.91） points in the control group， and the difference had statistical significance （P0.05）. The observation group had lower serum cholinesterase level as （323.62±