摘要
目的探讨旁路支气管肺泡灌洗术(BAL)治疗重度急性有机磷农药中毒(SAOPP)合并呼吸衰竭的临床疗效。方法选取2012年5月至2015年12月在重症医学科(ICU)治疗的SAOPP合并呼吸衰竭患者37例为观察组,在常规治疗的基础上给予旁路BAL。选取2009年1月至2012年4月ICU治疗的相同条件的患者37例作为对照组。比较两组患者住院第5、10、15天住院例数、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、气道峰压(PIP)、氧合指数、阿托品用量的变化;分析观察组在灌洗前后pH值、PaO_2、PaCO_2、PIP、氧合指数的变化。结果观察组住院第5、10天,PaO_2、氧合指数明显高于对照组(P<0.05),PaCO_2、PIP、阿托品用量明显低于对照组(P<0.05);观察组灌洗后pH值、PaO_2、PaCO_2、PIP、氧合指数变化与灌洗前比较差异有统计学意义(P<0.05);观察组第10天住院例数较对照组明显减少(P<0.05)。结论旁路BAL在治疗SAOPP合并呼吸衰竭患者时效果显著。
Objective To investigate the clinical efficacy of bypass bronchoalveolar lavage（ BAL） on severe acute organophosphorus pesticide poisoning（ SAOPP） combined with respiratory failure. Methods Thirty-seven cases of SAOPP complicated with respiratory failure from May 2012 to December 2015 in the intensive care unit（ ICU） were selected as observation group.The patients were treated by routine treatment,and the patients were treated by BAL. Thirty-seven patients with the same conditions from January 2009 to April 2012 were selected as the control group. Patients hospitalized in the 5th,10 th,15th day of hospitalization,arterial oxygen（ PaO_2）,arterial partial pressure of carbon dioxide（ PaCO_2）,peak airway pressure（ PIP） and the changes of oxygenation index,the dosage of atropine were compared between the two groups. The changes of pH,PaO_2,PaCO_2,PIP and oxygen index before and after lavage in the observation group were analyzed. Results In the observation group,PaO_2and the oxygenation index were significantly higher than those in the control group at the 5th,10 th day of hospitalization（ P〈0. 05）,while PaCO_2,PIP,dosage of atropine were significantly lower than those in the control group（ P〈0. 05）. In the observation group,the changes of pH value,PaO_2,PaCO_2,PIP,oxygenation index after lavage had significant difference compared with before lavage（ P〈0. 05）; The number of the tenth day hospitalization in observation group was less than that in the control group（ P〈0. 05）. Conclusion The bypass BAL is effective on severe AOPP combined with respiratory failure.
出处
《临床医学》
CAS
2016年第10期26-28,共3页
Clinical Medicine
关键词
重度急性有机磷农药中毒
呼吸衰竭
旁路支气管镜肺泡灌洗术
Severe acute organophosphorus pesticide poisoning
Respiratory failure
Bypass bronchialveolar lavage
