呼吸機使用在搶救有機磷農藥中毒中的效果

應莉　李剛

[關鍵詞] 呼吸機;搶救;有機磷中毒;氣道管理

[中圖分類號] R459.7? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）19-0108-04

Efficacy of applying ventilator in rescue of organophosphorus pesticide poisoning

YING Li? ?LI Gang

Department of Emergency，Zhejiang Provincial People′s Hospital，Hangzhou? ?310014，China

[Abstract] Objective To analyze the efficacy of applying ventilator in rescue of organophosphorus pesticide poisoning.Methods A total of 20 cases of patients with organophosphorus poisoning admitted to our hospital from August 2015 to September 2019 were selected and randomly divided into the control group and the study group.The control group was given conventional treatment， while the study group was given ventilator-assisted therapy on the basis of conventional treatment.The incidence of complications，surgical results and adverse reactions （ADRs） such as aspiration and airway damage were compared before and after treatment. Results The incidence of complications in the study group was significantly lower than that in the control group （P<0.05）. The number of ADRs such as aspiration and airway damage in the study group was significantly less than that in the control group （P<0.05）. The time of consciousness recovery， autonomic recovery and hospitalization time in the study group were all shorter than those in the control group （P<0.05）. Conclusion The application of ventilator-assisted breathing in patients with organophosphorus poisoning for airway management can improve the success rate of rescue，reduce complications and ADRs， restore self-consciousness as soon as possible，and shorten the hospitalization time，with high safety.Therefore，it is worthy of clinical promotion.

[Key words] Ventilator; Rescue; Organophosphorus poisoning; Airway management

在內科急診中，急性有機磷中毒是危險性較大的疾病，機體抑制有機磷農藥毒性時，先對體內的膽堿酯酶進行抑制，使乙酰膽堿逐漸蓄積，膽堿可以產生長時間的神經沖動，興奮過后再呈衰竭的癥狀。若患者的情況較為嚴重，則會由于昏迷、呼吸衰竭而死亡[1]。有機磷中毒患者死亡的原因是呼吸衰竭，常規治療很難密切監測身體指標，容易導致患者由于呼吸衰竭造成死亡，因此在常規治療不理想的背景下，采用呼吸機輔助患者呼吸，有利于及時發現患者的異常情況，及時氣管插管行機械通氣，挽救患者生命，使得患者死亡率降低至9%左右，對治療患者具有十分重要的意義。我院選取20例有機磷中毒患者，均通過呼吸機來輔助患者呼吸，從而進行有效治療，本研究旨在探究臨床采用呼吸機輔助呼吸搶救有機磷中毒的氣道管理，現報道如下。

1 資料與方法

1.1 一般資料

我院選取2015年8月至2019年9月收治的20例有機磷中毒患者，研究組男7例，女13例，年齡23～77歲，平均（41.6±4.9）歲。對照組男7例，女13例，年齡23～77歲，平均（41.6±4.9）歲。納入標準[2]：①患者均符合第7版《內科學》中有機磷農藥中毒的診斷標準。②患者存在呼吸困難。③患者及其家屬均知情并同意簽署本研究。排除標準[3]：患者未表現出急性有機磷中毒毒蕈堿和煙堿樣癥狀。

本研究中所有患者均了解病情狀況，以及本研究采用的治療方案，了解本研究的內容、目的，兩組患者的臨床資料具有一般可比性（P>0.05），且經過醫院醫學倫理委員會批準。