Severe Acute Organophosphorus Pesticide Poisoning Research Articles

Application of different airway opening approaches in patients with intermediate syndrome following severe acute organophosphorus pesticide poisoning

目的 比较急性有机磷农药中毒(AOPP)重型中间综合征(IMS)患者呼吸支持过程中选择不同气道开放方式对病程的影响.方法 选择2004年12月至2007年12月入住ICU的重型IMS患者73例,按气道开放方式分为:经口气管插管组22人,常规气管切开组25人,经皮扩张气管切开组26人,比较各组患者阿托品用量、氯解磷定用量、肺部感染、机械通气时间、留置人工气道时间、ICU住院时间的差异.结果 常规气管切开组、经皮扩张气管切开组机械通气时间分别为(9.2±2.5)、(8.6±2.5)d,留置人工气道时间分别为(13.6±2.5)、(13.7±2.1)d,ICU住院时间分别为(15.1±2.6)、(15.0±2.1)d,均明显低于经口气管插管组,差异均有统计学意义(P<0.05).结论 重型IMS患者尽早行气管切开术有利于其呼吸功能的恢复。

Therapeutic efficacy of hemoperfusion combined with comtinuous vein-vein hemofiltration in treatment of acute severe organophosphorus pesticide poisoning

目的 评价血液灌流加连续性静脉-静脉血液滤过治疗重度有机磷中毒的价值.方法 53例AOPP患者分为两组,对照组21例行传统治疗,治疗组32例在常规治疗基础上联合运用血液灌流及持续静-静脉血液滤过治疗.观察比较两组的治疗效果.结果 治疗组的昏迷持续时间、胆碱酯酶活力恢复时间、住院时间、阿托品应用总量均小于对照组,有显著性差异(P＜0.01).反跳发生率、中间综合症发生率均小于对照组,有显著性差异(P＜0.0 5).结论 血液灌流加连续性静脉-静脉血液滤过治疗重度有机磷中毒更为安全而有效。

Clinical observation of bedside hemoperfusion and repeated gastrolavage and purgation on acute severe organophosphorus pesticide poisoning

目的 研究血液灌流联合洗胃、导泻治疗急性重度有机磷农药中毒的效果.方法 回顾性分析自2003年7月至2006年6月重度有机磷农药中毒病历资料完整的72例临床资料.全部病例均在急诊科洗胃及内科常规处理后转入ICU并给予血液灌流治疗,将内科常规治疗、血液灌流同时再次反复洗胃、导泻的34例作为治疗组,将仅内科常规治疗、血液灌流,未再次洗胃、导泻的38例作为对照组.结果 治疗组治疗开始至清醒时间,氯磷定、阿托品用量,住院时间均较对照组明显减少,治愈率提高,两组比较差异有统计学意义.结论 内科常规治疗加早期血液灌流治疗急性重度有机磷农药中毒安全有效,早期血液灌流同时反复洗胃、导泻,可以进一步提高治愈率。

Effect of the pre-hospital systematic treatment on prognosis patients of with severe acute organophosphorus pesticide poisoning

To investigate if the duration from poisoning to treatment (no treatment period) is related to the prognosis of patients with severe acute organophosphorus pesticide poisoning (SAOPP). One hundred and seventy-four patients with the pre-hospital systematic treatment served as the treatment group while 160 patients going to the hospital by themselves without treatment or rejecting gastrolavage served as the control group. Patients in both groups were treated by gastrolavage, pralidoxime chloride, atropine and other expectant treatment. The duration of no treatment period, death, and severe complication were observed. The time of disappearance of symptoms, the recovery time of acetyl cholinesterase (AChE), atropinization time, atropine dosage, pralidoxime chloride dosage, naloxone dosage, hospitalization days and other targets were also observed. The duration of no treatment period in treatment group [(1.2 +/- 0.3) h] was significantly shorter than that in control group [(2.8 +/- 0.5) h, (P < 0.01)]. The mortality rate in treatment group was 6.32% while that in control group 22.5% (P < 0.01). The incidence of respiratory failure, heart injury, brain injury, atropine poisoning, intermediate syndrome, liver injury in treatment group (12.64%, 5.75%, 8.62%, 1.72%, 4.60%, 5.17% respectively) were lower than those in control group (25.63%, 13.75%, 17.50%, 6.25%, 7.50%, 9.38% respectively, P < 0.05 or P < 0.01). The time of symptoms disappearance, the recovery time of AChE, atropinization time, atropine dosage, pralidoxime chloride dosage, naloxone dosage, hospitalization days in treatment group were significantly superior to those in control group (P < 0.05 or P < 0.01). The pre-hospital systematic treatment can improve the prognosis of the patients with SAOPP, which is worth popularizing and using.