呼吸机使用在抢救有机磷农药中毒中的效果

应莉　李刚

[关键词] 呼吸机;抢救;有机磷中毒;气道管理

[中图分类号] R459.7          [文献标识碼] B          [文章编号] 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

在内科急诊中，急性有机磷中毒是危险性较大的疾病，机体抑制有机磷农药毒性时，先对体内的胆碱酯酶进行抑制，使乙酰胆碱逐渐蓄积，胆碱可以产生长时间的神经冲动，兴奋过后再呈衰竭的症状。若患者的情况较为严重，则会由于昏迷、呼吸衰竭而死亡[1]。有机磷中毒患者死亡的原因是呼吸衰竭，常规治疗很难密切监测身体指标，容易导致患者由于呼吸衰竭造成死亡，因此在常规治疗不理想的背景下，采用呼吸机辅助患者呼吸，有利于及时发现患者的异常情况，及时气管插管行机械通气，挽救患者生命，使得患者死亡率降低至9%左右，对治疗患者具有十分重要的意义。我院选取20例有机磷中毒患者，均通过呼吸机来辅助患者呼吸，从而进行有效治疗，本研究旨在探究临床采用呼吸机辅助呼吸抢救有机磷中毒的气道管理，现报道如下。

1 资料与方法

1.1 一般资料

我院选取2015年8月至2019年9月收治的20例有机磷中毒患者，研究组男7例，女13例，年龄23～77岁，平均（41.6±4.9）岁。对照组男7例，女13例，年龄23～77岁，平均（41.6±4.9）岁。纳入标准[2]：①患者均符合第7版《内科学》中有机磷农药中毒的诊断标准。②患者存在呼吸困难。③患者及其家属均知情并同意签署本研究。排除标准[3]：患者未表现出急性有机磷中毒毒蕈碱和烟碱样症状。

本研究中所有患者均了解病情状况，以及本研究采用的治疗方案，了解本研究的内容、目的，两组患者的临床资料具有一般可比性（P>0.05），且经过医院医学伦理委员会批准。