| Objective:Through the intervention of different feeding time,the best time of early feeding for patients with oral organophosphorus pesticide poisoning was discussed,so as to provide theoretical basis for rational feeding time of patients with the disease,guide clinical nursing work,and improve the success rate of treatmentMethods:A total of 128 patients with acute oral organophosphorus pesticide poisoning admitted to a first-class hospital in shandong province from June 2018 to November 2019 were selected by convenient sampling.The patients were divided into groups A,B,C and D according to the different feeding time after poisoning on admission.Group A was the patient who took food<6h after poisoning.Group B was a group of patients who took food≥6h and<12h after poisoning.Group C was a group of patients who took food≥12h and<24h after poisoning.Group D was a group of patients who took food≥24h after poisoning.There were 32 cases in group A,30 cases in group B,34 cases in group C and 32 cases in group D,including 62 males and 66 females.All patients in the four groups could be fed on admission,and the feeding methods were consistent.Treatment is consistent for patients with the same condition.All patients followed the principles of reactivator,anticholinergic,early,combination,adequate and repeated treatment.The cholinesterase activity,liver damage,kidney damage,myocardial damage,the incidence of rebound after poisoning,the disappearance time of clinical symptoms of poisoning and the length of hospital stay in the four groups were compared 24h,48h,72h and 120h after poisoning.Results:1.The four groups of patients with acute oral organophosphorus pesticide poisoning had no statistically significant difference in terms of the types of organophosphorus pesticides in terms of age,gender,occupational education level,disease grade,hemoperfusion cases and other baseline data(P>0.05).2.The recovery of cholinesterase activity in four groups of patients with acute oral organophosphorus pesticide poisoning at different time points(24h,48h,72h,120h after poisoning)was compared,and the difference was statisticallysignificant(F=3.933,P<0.05;F=7.439,P<0.001;F=13.716,P<0.001;F=13.135,P<0.001).Further pair wise comparisons show that:①24h after poisoning:the cholinesterase activity of group A was higher than that of group C and D,and the difference was statistically significant(P<0.05;P<0.01).②48h after poisoning:the cholinesterase activity of group A was higher than that of group B,C and D,and the difference was statistically significant(P<0.001).③72h after poisoning:the cholinesterase activity of group A was higher than that of group B,C and D,and the difference was statistically significant(P<0.001).④120h after poisoning:the cholinesterase activity of group A was higher than that of group B,C and D,and the difference was statistically significant(P<0.001).After poisoning 24h,48h,72h,120h,and the recovery of cholinesterase activity in B,C and D groups showed no statistically significant difference(P>0.05).The cholinesterase activity in A group was higher than that in B group for 24h,but the difference was not statistically significant(P>0.05).3.The disappearance time of clinical poisoning symptoms in the four groups was pally compared,and the difference was statistically significant(F=7.361,P<0.001).The results showed that the disappearance time of clinical poisoning symptoms in group A was shorter than that in group C and group D,and the difference was statistically significant(P<0.05).The disappearance time of clinical poisoning symptoms in group B was shorter than that in group C and group D,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the time of disappearance of clinical poisoning symptoms between group A and group B,and between group C and group D(P>0.05).4.There was no statistically significant difference between the four groups in the incidence of liver injury after eating(χ2=5.487,P>0.05).Fisher’s exact test was used to compare the incidence of rebound kidney injury and other complications after gastrointestinal reaction poisoning after eating among the four groups,and the difference was not statistically significant(P>0.05).5.The incidence of myocardial injury in the four groups was statistically significant(χ2=9.209,P<0.05).The incidence of myocardial injury in group A was lower than that in group D,and the difference was statistically significant(P<0.05).There was no significant difference among other groups(P>0.05).6.The hospital stay time of patients in the four groups was pairwise compared,and the difference between group A and control group D was statistically significant(F=3.541,P<0.05).There was no significant difference in hospital stay among the other groups(P>0.05).Conclusion:1.For patients with acute organophosphorus pesticide poisoning,early feeding is beneficial to the recovery of cholinesterase activity.2.For patients with acute oral organophosphorus pesticide poisoning,early feeding can reduce the clinical poisoning symptoms;The earlier the feeding time,the earlier the clinical poisoning symptoms disappeared,and did not increase the incidence of gastrointestinal reactions.3.In patients with acute organophosphorus pesticide poisoning,early feeding did not increase the incidence of liver injury,kidney injury and other complications after poisoning.4.In patients with acute oral organophosphorus pesticide poisoning,early feeding can promote the recovery of myocardial injury.5.For patients with acute organophosphorus pesticide poisoning,the best time to eat early is within 6h after poisoning. |
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