摘要
目的探讨与急性有机磷农药中毒(AOPP)所致上消化道出血相关的临床因素,寻找防治上消化道出血的有效措施。方法选择2005年1月至2009年9月中南大学湘雅医院急诊科收治的重度AOPP患者49例,根据临床症状分为上消化道出血组(A组,26例)和非上消化道出血组(B组,23例),观察上消化道出血发生的时间、次数、原因,两组血糖、急性生理学及慢性健康状况评分Ⅱ(APACHEⅡ评分)、血清胆碱酯酶及预后的差异。结果 AOPP致上消化道出血的原因依次为毒物损伤胃黏膜、洗胃损伤、应激性溃疡;A组APACHEⅡ评分明显高于B组,血清胆碱酯酶明显低于B组;APACHEⅡ评分与上消化道出血呈正相关,血清胆碱酯酶与上消化道出血呈负相关。结论 APACHEⅡ评分及血清胆碱酯酶都可用于反映AOPP时上消化道出血的发生情况。
Objective To investigate the correlated clinical factors of upper gastrointestinal hemorrhage induced by acute organophosphorus pesticide poisoning（AOPP） and look for effective method for the prevention and treatment of upper gastrointestinal tract bleeding（UGTB）. Methods 49 patients with severe AOPP were divided into UGTB group（ group A ,26 cases）and non-UGTB group（ group B ,23 eases）. The time ,frequency and causes of UGTB were observed. We also observed the differences in acute physiology and chronic health evaluation Ⅱ （ APACHE Ⅱ ） ,blood glucose and cholinesterase in serum. Results The causes of UGTB induced by AOPP were poison damage of stomach mucous membrane, gastric lavage damage and irritability ulcer; APACHE Ⅱ scores of group A were more than those of group B obviously; the level of eholinesterase was lower in group A. Correlation analysis showed that the APACHE Ⅱ scores had positive correlation and the level of cholinesterase had negative correlation with UGTB induced by AOPP. Conclusion Both the APACHE II scores and level of cholinesterase can reflect the UGTB induced by AOPP. Active treatment of the primary disease and stress status and often the operation of gastric lavage are important ways to prevent and treat UGTB induced by AOPP.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2010年第6期556-557,共2页
Chinese Journal of Practical Internal Medicine
关键词
急性有机磷农药中毒
上消化道出血
急性生理学及慢性健康状况评分Ⅱ
胆碱酯酶
acute organophosphorus pesticide poisoning
acute physiology and chronic health evaluation Ⅱ
upper gastrointestinal tract bleeding
cholinesterase
