| PurposeBy the retrospective analysis on several different treatment methods for patientswith serious AOPP, it primarily indicates that constant gastric lavage has clinical effecton patients with serious AOPP combined with HP; and then it further compares thistreatment method with simple constant gastric lavage in terms of their effect onclearance rate of blood poison, incidence of intermediate syndrome, ventilatoremployment and offline time, ICU days as well as medical expenses, which willprovides basis for a more scientific and effective clinical treatment methodappropriately.MethodsFirst, it collects90cases of patients with serious AOPP in the emergencydepartment of our hospital from Jan2008to Dec2011, and they are divided into threegroups according to the treatment methods they accepted, which are simple gastriclavage group of27cases, constant gastric lavage group of36cases and constant gastriclavage combined with HP group of27cases. The simple gastric lavage group areaccommodated in the wards for regular treatment(anticholinergics as well as CHEreactivators) after one-time emergency treatment; while for the constant gastric lavage,patients will be given constant gastric lavage at intervals by tubes from nose in theirward after the emergent lavage. The process will last for72hours with1000ml everytwo hours, and the regular treatment is similar to simple lavage group. Based on thetreatment above, HP treatment will be added for the third group. Then data will becounted on patients of three groups regarding their vital signs including mean arterial pressure, GCS score, liver and kidney function, serum CHE activity, dosage of atropineas well as mortality rate with further analysis. According to whether to accept HPtreatment or not, serious dichlorvos poisoning patients in the emergency department ofour hospital from Jan2012to Dec2013can be further divided into two groups, whichare constant gastric lavage group with15cases and constant gastric lavage combinedwith HP group of15cases. Patients of each group were drawn blood samples fortexicology tests during their emergency treatment, first-time lavage as well as withinthree days after that respectively. Poison clearance of patients in the two groups can becounted; besides, incidence of intermediate syndrome of patients in the two group aswell as the ventilator employment rate and offline time can be observed. MeanwhileICU days as well as hospitalization expenses of patients can be checked.Results1.According to the retrospective analysis result, the mean arterial pressure andGCS score of constant gastric lavage combined with HP group are obviously higherthan the control group; while the recovery time of liver and kidney functions, CHErecovery time, total atropine used in the treatment as well as mortality rate are all lowerthan the constant lavage group.(P＜0.05)；2.According to the prospective comparative research results, the OP clearance rateof constant gastric lavage combined with HP is obviously higher than the constantgastric lavage group (P＜0.05); the incidence of intermediate syndrome in constantgastric lavage combined with HP group is less than constant gastric lavage group but theincidence has no statistically difference (P＞0.05)； the mechanical ventilation rate aswell as the employment period of ventilator are obviously lower than the constantgastric lavage group (P＜0.05)； the average ICU days of constant gastric lavagecombined with HP are significantly lower than the constant gastric lavage group (P＜0.05)， but the two groups have no statistically difference regarding hospitalizationexpenses. Conclusions1.Constant gastric lavage combined with HP is better for the treatment of seriousAOPP on the improvement of vital signs compared to simple gastric lavage and constantgastric lavage with low mortality rate.2.The superiority of constant gastric lavage combined with HP lies in itsacceleration of poisoning clearance.3.The employment of constant gastric lavage combined with HP for the treatmentofAOPP can reduce the usage of medical resources. |
PDF Full Text Request