摘要
目的 观察急性百草枯中毒患者碳酸氢钠洗胃、雾化吸入与静脉注射三联法预防肺渗出与纤维化的效果.方法 收集来院治疗的38例百草枯中毒患者为观察组,用质量浓度为1.5％的碳酸氢钠溶液洗胃,采用质量浓度为5％碳酸氢钠溶液10～15 ml雾化吸入2次/d;并5％碳酸氢钠溶液100ml快速静脉滴注,2次/d,连续应用5～7 d.抽取
既往资料完整未用碳酸氢钠患者38例作对照组.比较两组患者肺部HRCT评分及治疗后7d的肝肾功能指标.结果 对照组百草枯中毒患者3、7、30 d肺HRCT平均评分达到2.87.3.12、2.13,HRCT示呈现出磨玻璃影、网格影和蜂窝影等渗出及纤维化征象.观察组患者3、7、30d肺HRCT平均评分分别为1.95、2.20、1.67,HRCT示肺渗出及纤维化征象显著减少,两组HRCT评分比较,差异有统计学意义（P＜0.01）.与对照组比较,观察组百草枯中毒患者血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）活力明显降低,血清尿素氮（BUN）、肌酐（Cr）水平明显降低,差异有统计学意义（P＜0.01）.结论 碳酸氢钠洗胃、雾化吸入与静脉注射联合应用可使百草枯中毒患者肺渗出及纤维化的发生程度减轻、范围减少,对肝肾功能有明显的保护作用.
Objective To observe the prevention effects of patients with lung exudation and pulmonary fibrosis induced by paraquat poisoning in sodium bicarbonate （SB） with gastric lavage,atomization inhalation and intravenous injection.Methods To collect 38 patients with paraquat poisoning in hospital,after poison immediately with gastric lavage of 1.5% SB,and atomization inhalation of 5%SB 10～15 ml twice daily and intravenous injection of 5% SB twice a day,continuous application of 5～7 days.and the HRCT score and liver and kidney function was performed on patients with lung after treatment.And the extraction of 38 SB patients with previously untreated with SB for comparison.Results Lung HRCT average score in 72 h,7 d,30 d on patients with paraquat poisoning untreated with SB reached 2.87,3.12,2.13,HRCT display shows that the appearance of the wear glass shadow,grid shadow,honeycomb shadow,and other signs of fibrosis.Average HRCT reached 1.95,2.20,1.67 on patients treated with SB,signs of lung exudation and fibrosis was significantly reduced,compare two groups,there was statistically significance （P〈0.01）.And compared to the control group,activity of serum alanine aminotransferase （ALT） and aspartic acid transaminase （AST） decreased significantly in group of paraquat poisoning with triple application of SB,the level of serum urea nitrogen （BUN） and creatinine （Cr） significantly decreased,the difference is statistically significant （P〈0.01）.Conclusion The triple application of SB can reduced the pulmonary fibrosis and effusion induced by paraquat poisoning,and protective effect on the function of liver and kidney is obvious,suggesting that the method for treatment of paraquat poisoning,prevention of paraquat lung and improve survival rate has the exact effect.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
2015年第9期693-694,共2页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
百草枯
中毒
肺纤维化
碳酸氢钠
Paraquat
Poisoning
Pulmonary fibrosis
Sodium bicarbonate
