液体复苏治疗有机磷中毒对患者血清乳酸水平和CRP的影响

为了探讨在应用目标指导下液体复苏对有机磷农药中毒休克患者的抢救效果影响,本研究选取54例有机磷农药中毒休克患者,平均分成两组,其中27例患者采用基础治疗+目标指导下液体复苏治疗(A组)、另外27例患者采用基础治疗+常规抗休克治疗(B组),对比两组患者的救治效果差异。治疗前,A组和B组患者的SBP、血乳酸、CRP、APACHEⅡ评分、CHE、LDH、淀粉酶、CK、AST差异无统计学意义(p>0.05);治疗后12 h、24 h、48 h,A组患者的SBP显著高于B组(p<0.05),血乳酸显著低于B组(p<0.05);治疗后24 h、48 h,A组的CHE显著高于B组(p<0.05),CRP、APACHEⅡ评分、LDH、淀粉酶、CK、AST均显著低于B组(p<0.05);A组和B组患者的阿托品用量、血清CHE恢复时间、反跳率、治愈率、住院时间差异无统计学意义(p>0.05);A组和B组患者的MODS发生率、呼吸衰竭发生率、肺部感染发生率差异无统计学意义(p>0.05);A组患者的应激性溃疡发生率11.11%显著低于B组的37.04%(p<0.05)。本研究表明,应用目标指导下液体复苏对有机磷农药中毒休克患者的生命体征恢复具有积极意义,同时可以减轻患者并发症的发生,但是并不能显著地提高患者的抢救成功率。

Effect of Liquid Resuscitation on Serum Lactic Acid Level and CRP in Patients with Organophosphorus Poisoning

To explore the effect of liquid resuscitation on the rescue of organophosphorus pesticide poisoning shock patients under the guidance of application target, in this study, 54 patients with organophosphorus pesticide poisoning shock were selected and divided evenly into two groups. 27 cases were treated with basic treatment + liquid resuscitation under the guidance of target(group A), another 27 cases were treated by basic treatment + conventional anti-shock treatment(group B), and the differences of treatment effects were compared between the two groups.Before the treatment, there was no significant difference in SBP, blood lactic acid, CRP, APACHE Ⅱ score, CHE,LDH, amylase, CK and AST between group A and group B(p>0.05);12 h, 24 h, 48 h after treatment, the SBP of group A patients was significantly higher than that of B group(p<0.05), and the blood lactic acid in group A was significantly lower than that in group B(p<0.05);24 h, 48 h after treatment, CHE in A group was significantly higher than that in B group(p<0.05), CRP, APACHE Ⅱ score, LDH, amylase, CK, and AST were significantly lower than those in B group(p <0.05);Atropine dosage, serum CHE recovery ti me, the rebound rate, cure rate,and hospitalization time between group A and group B patients had no significant difference(p >0.05);MODS incidence, the incidence of respiratory failure, and pulmonary infection rate between group A and group B patients showed no significant difference(p>0.05);The incidence of stress ulcer in group A(11.11%) was significantly lower than that in group B(37.04%)(p<0.05). This study showed that liquid resuscitation under the guidance of the target might have a positive effect on recovery of vital signs in patients with organophosphorus pesticide poisoning shock,and could reduce the incidence of complications, but it cannot significantly improve the success rate of rescue.