重复洗胃对有机磷农药中毒病人血胆碱脂酶活性的影响
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[摘要]为了探讨口服有机磷农药中毒后保留胃管重复洗胃对血胆酯酶活性的影响。将180例口服有机磷农药中毒病人随机分为观察组和对照组，观察组96例，保留胃管重复洗胃；对照组84例，按常规法洗胃。观察两组每24h血胆碱酯酶活性变化。结果轻度中毒时，两组血胆碱酯酶活性比较，差异无显著性(P>0.05)；中、重度中毒时，观察组血胆碱酯酶活性下降幅度小、回升快，与对照组比较，差异有极显著性(P<0.01)。提示保留胃管重复洗胃可将体内残留农药排出体外，血胆碱酯在无残毒继续抑制的情况下可迅速恢复活性。
关键词：有机磷农药中毒洗胃胆碱酯酶
Effect of Repeated Gastrolavage on the Blood Cholinesterase Activity
in Organophosphorus Pesticide Poisoning
Zhang Wei Ying
People’s Hospital of Jinxiang of Shangdong Province，Jinxiang 272200
AbstractThe effect lf repeated gastrolavage with retained gastric canal on blood cholinesterase activity in organophosphorus poisoning via gastrointestine was studied 180cases of poisoning due to oral organophosphorus pesticide were randomly divided ynto observation group (n=96，receiving repeated gastrolavage)and control group (n=84，receiving routine gastrolavage).The changes in blood cholinesteraseactivity in an interval of 24 h in the two groups were observed .The results showed that in mild poisoning，there was no significant difference in blood cholinesterase activity in the observation groups (p>0.05).However，in moderate or severe poisoning，blood cholinesterase activity in the observation group hada less decrease and returned to normal more quickly as compared with control group (p<0.01).It was suggested that repeated to normal more quickly as compared with control group (p<0.01).It was suggested gastrolavage through retained gastric canal could eliminate the residual pesticide from the body.The blood cholinesterase could be activated rapidly.
Keywords：organophosphorus pesticide poisoing gastrolavage cholinesterase
中图分类号：R139.3文献标识码：B文章编号：1004-7484(2010)12-0045-02
为了探讨口服有机磷农药中毒后保留胃管重复洗胃对血胆碱脂酶活性的影响，2007年6月至2009年12月对96例口服有机磷中毒病人采用保留胃管重复洗胃，测定其胆碱脂酶活性，并与常规法单次彻底洗胃者进行对比，结果报告如下。
1临床资料
1.1一般资料
本组180例，随机分为观察组和对照组，观察组96例，。其中久效磷中毒23例，辛硫磷17例，敌敌畏13例，甲胺磷10例，乐果9例，“3911”9例，“1605”8例，混合农药7例。根据急性有机磷农药中毒诊断及分级诊断标准[1]，轻度中毒18例，中度49例，重度29例。对照组84例.其中敌敌畏中毒23例，辛硫磷19例，久效磷14例，乐果13例，甲胺磷6例，“1605”4例，“3911”3例，混合农药2例。轻度中毒14例，中度46例，重度24例。
1.2方法
观察组首次洗胃后保留胃管24h，接胃肠减压器引流胃内残留洗胃液，且每4h重复洗胃1次，于未次洗胃毕拔掉胃管。对照组按常规法实行单次彻底洗胃。两组于入院时及以后每24h抽静脉血采用纸片法测定血胆碱酯酶活性，测定数据用x±s表示，进行t检验。
2结果
入院后72h内观察组死亡3例，120h内对照组死亡5例。两组存活病人血胆碱酯酶活性测定结果见表1。
表1两组病人血胆碱酯酶活性的变化(x±s)
程度组别例数入院时入院后(h)出院时
24487296120144
轻观察组180.62±0.080.60±0.080.65±0.060.65±0.070.70±0.06……0.76±0.05
对照组140.60±0.080.62±0.060.65±0.060.67±0.060.70±0.06……0.75±0.05
中观察组490.42±0.060.32±0.080.32±0.080.33±0.070.38±0.080 ......
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