周昌虎

[摘要] 目的 研究急性有机磷农药中毒致呼吸衰竭患者出现呼吸衰竭等主要临床因素，以此作为治疗急性有机磷农药中毒的临床依据。 方法 方便选取该院2015年1月—2017年12月收治的256例急性有机磷农药中毒致呼吸衰竭患者，根据患者是否出现呼吸衰竭分分为研究组和对照组，每组128例患者，对两组实施相同的急救与治疗方法，分析两组治疗效果、转归情况差异，分析呼吸衰竭对患者治疗的影响，总结导致患者呼吸衰竭的主要因素。 结果 研究组治疗有效率为85.93%，对照组治疗有效率为96.87%（χ2=7.25，P<0.05），两组阿托品用量、血糖、胆碱酯酶等指标差异有统计学意义（P<0.05）。结论 急性有机磷农药中毒致呼吸衰竭临床高发，并对患者的抢救与治疗产生不利影响，临床可利用观察患者胆碱酯酶与脏器损伤数量观察患者是否存在呼吸衰竭风险，值得临床关注。

[关键词] 急性有机磷农药中毒；呼吸衰竭；临床因素；治疗效果；预后影响

[中图分类号] R459.7 [文献标识码] A [文章编号] 1674-0742（2018）06（b）-0034-03

Study on Related Clinical Factors of Respiration Failure Caused by the Acute Organophosphorus Pesticide

ZHOU Chang-hu

Department of Emergency， Affiliated Hospital of Xuzhou Medical University， Xuzhou， Jiangsu Province， 221000 China

[Abstract] Objective To research the major clinical factors of respiration failure caused by the acute organophosphorus pesticide thus providing clinical basis for the treatment of acute organophosphorus pesticide. Methods 256 cases of patients with respiration failure caused by the acute organophosphorus pesticide admitted and treated in our hospital from January 2015 to December 2017 were convenient selected and divided into two groups with 128 cases in each according to whether the patients had the respiration failure or not， and the two groups used the same emergency and treatment method， and the treatment effect and outcome situation of the two groups were analyzed， and the effect of respiration failure on the treatment of patients was analyzed， and the major factors of respiration failure were summarized. Results The treatment effective rate in the research group and in the control group was respectively 85.93% and 96.87%（χ2=7.25，P<0.05）， and the differences in the atropine dosage， blood glucose， cholinesterase between the two groups were statistically significant（P<0.05）. Conclusion The clinical incidence rate of respiration failure caused by the acute organophosphorus pesticide is high， which can have an adverse effect on the rescue and treatment of patients， and we can use the cholinesterase and number of organs injuries to observe whether there are respiration failure risks， and it is worth clinical attention.

[Key words]Acute organophosphorus pesticide； Respiration failure； Clinical factor； Treatment effect； Prognosis and effect

急性有機磷农药是农业生产中经常使用的药物种类，但如果误食或误服，通过血液吸收进入各部分脏器，就会造成人体组织器官受损，造成神经突触、神经肌肉接头处中毒，此时患者体内磷酰化胆碱酯酶含量急剧增加，胆碱酯酶活性受到严重破坏，各部分器官受到较为严重的损伤，一些患者甚至产生呼吸衰竭症状，无法保证患者呼吸效果的前提下，患者的生命安全受到严重的威胁。我国每年由于有机磷农药中毒致死的患者占10%左右。多数患者在发病后出现剧烈反应，需及时到院急救，才能挽救患者的生命[1]。临床对有机磷农药导致的急性中毒有较为系统的抢救与治疗方法，但通过临床研究后发现，不同症状类型、不同病情程度下患者的预后与转归效果也受到不同程度的影响，尤其在出现呼吸衰竭患者与未出现呼吸衰竭患者之间，预后效果存在一定的差异[2]。……