摘要
目的：探讨临床给予重度有机磷农药中毒患者采取早期肠内营养支持治疗对预后的影响。方法选取重度有机磷农药中毒患者56例，按随机数字表法分为A、B两组。两组均常规进行农药中毒抢救治疗。其中A组30例于48～72 h内使用营养泵开通肠内营养。B组则在常规抢救基础上，于72 h至5 d内开通肠内营养。比较两组治疗过程中意识恢复时间，胆碱酯酶（CHE）恢复至正常60％的时间，中间综合征发生率，腹痛、腹胀、呕吐、返流、腹泻等胃肠道并发症发生率，呼吸机相关性肺炎（VAP）发生率，多脏器功能障碍综合征（MODS）发生率。结果 A组意识恢复时间（3．6±0．8）d，较B组的（4．1±0．6）d 显著缩短（t＝2.612，P＜0．01）；A组胆碱酯酶恢复正常60％时间为（5．5±1．3）d，较B组的（6．3±1．1）d缩短（t＝2．464， P＜0．05）；A组中间综合症发生率（3．3％）、VAP发生率（13．3％）均显著低于B组（38．5％、46．2％）（χ^2＝4.691，P＜0．05；χ^2＝7．352，P＜0．01）；A组MODS 发生率（13．3％）较B组（38．5％）减少（χ^2＝4．691，P＜0.05）；A组住ICU时间（8．0±1．2）d，较B组的（12．0±2．4）d显著缩短（t＝7．705，P＜0．01）。两组胃肠道反应差异无统计学意义（P＞0．05）。结论对重度有机磷农药中毒患者使用营养泵早期开通肠内营养是安全有效的，值得临床借鉴及推广。
Objective To explore the clinical curative effect of early enteral nutritional support for acute se-vere organophosphorus pesticide poisoning.Methods 56 cases with acute severe organophosphorus pesticide poison-ing were selected and divided into group A and group B in accordance with the random number table.Both groups were given conventional emergency treatment.Enteral nutrition support with nutrition pump was applied for 30 cases of group A in 48 -72hours,while group B in 72h -5d.The time of consciousness recovery,CHE increase to normal 60%,the incidence rate of intermediate syndrome,gastrointestinal complications of abdominal pain,abdominal disten-sion,vomiting,reflux,diarrhea,VAP,MODS of the two groups of patients were compared.Results The time of con-sciousness recovery （3.6 ±0.8）d in group A was lower than that of group B（4.1 ±0.6）d （t=2.612,P〈0.01）, the CHE increase to normal 60%（5.5 ±1.3）d in group A was lower than that of group B（6.3 ±1.1）d（t=2.464, P〈0.05）,the incidence rate of intermediate syndrome（3.3%）in group A was lower than that of group B（38.5%） （χ^2 =4.691,P〈0.05）,the VAP of 13.3% in group A was lower than that of group B（46.2%）（χ^2 =7.352,P〈0.01）,the MODS of 13.3% in group A was lower than 38.5% of group B（χ^2 =4.691,P〈0.05）,the duration in ICU of （8.0 ±1.2）d in group A was lower than （12.0 ±2.4）d of group B（t=7.705,P〈0.01）.There was no sig-nificant difference of gastrointestinal complications between the two groups （P 〉0.05 ）.There was no significant difference of gastrointestinal complications between the two groups （P〉0.05）.Conclusion Early enteral nutritional support is effective and safe for acute severe organophosphorus pesticide poisoning and worthy of promotion.
出处
《中国基层医药》
CAS
2015年第8期1173-1176,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
肠道营养
有机磷
农药
急性
中毒
治疗
Enteral nutrition
Organophosphoras
Pesticide
Acute
Poisoning
Treatment
