本文關(guān)鍵詞： 百草枯 中毒 預(yù)后 進(jìn)食時(shí)間 急性肺損傷 肺纖維化　出處：《河北醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:對(duì)滄州市人民醫(yī)院自2009年1月至2013年9月收治的254例急性百草枯中毒患者進(jìn)行回顧性分析,了解不同時(shí)間進(jìn)食對(duì)患者的并發(fā)癥及預(yù)后情況是否有影響,為該病患者的合理進(jìn)食時(shí)間提供科學(xué)依據(jù),提升救治成功率。方法:回顧性收集2009年1月至2013年9月就診于滄州市人民醫(yī)院急診科254例急性百草枯中毒患者的病例資料,按照病情輕重將納入研究的患者分成3組,輕型53例,中-重型72例,爆發(fā)型129例,對(duì)每組患者按照不同的進(jìn)食時(shí)間分成6個(gè)時(shí)間段,統(tǒng)計(jì)分析不同進(jìn)食時(shí)間患者的并發(fā)癥及預(yù)后情況,包括急性肺損傷/肺纖維化、急性腎損傷、急性肝損傷、存活情況。結(jié)果:對(duì)納入研究的254例患者進(jìn)行統(tǒng)計(jì)學(xué)分析,不同進(jìn)食時(shí)間對(duì)各種并發(fā)癥及預(yù)后的影響均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。但進(jìn)一步分型后發(fā)現(xiàn),輕型患者共53例,不同進(jìn)食時(shí)間對(duì)存活率的影響,P0.01,有統(tǒng)計(jì)學(xué)意義;其中在12小時(shí)時(shí)間段進(jìn)食的患者存活率最低(80.00%),44小時(shí)時(shí)間段進(jìn)食的存活率最高(100.00%);進(jìn)食時(shí)間對(duì)并發(fā)急性肺損傷/肺纖維化、急性腎損傷、急性肝損傷的影響無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。中-重型患者共72例,不同進(jìn)食時(shí)間對(duì)存活率、急性肺損傷/肺纖維化、急性腎損傷的影響,P0.01,有統(tǒng)計(jì)學(xué)意義;在12、13-20小時(shí)時(shí)間段進(jìn)食的患者存活率最低(50.00%),44小時(shí)時(shí)間段進(jìn)食的存活率最高(71.43%);在44小時(shí)時(shí)間段進(jìn)食的患者并發(fā)急性肺損傷/肺纖維化的發(fā)生率最低(28.57%),在13-20小時(shí)時(shí)間段進(jìn)食的發(fā)生率最高(60.00%);在12小時(shí)時(shí)間段進(jìn)食的患者并發(fā)急性腎損傷的發(fā)生率最低(33.33%),37-43小時(shí)時(shí)間段進(jìn)食的發(fā)生率最高(57.14);不同進(jìn)食時(shí)間對(duì)發(fā)生急性肝損傷的影響無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。爆發(fā)型患者共129例,不同進(jìn)食時(shí)間對(duì)發(fā)生急性肺損傷/肺纖維化、急性腎損傷、急性肝損傷的影響,P0.01,有統(tǒng)計(jì)學(xué)意義;進(jìn)食時(shí)間越晚的患者預(yù)后相對(duì)越好,其中在44小時(shí)時(shí)間段進(jìn)食的患者并發(fā)急性肺損傷/肺纖維化、急性腎損傷、急性肝損傷的發(fā)生率最低(分別為74.07%、74.07%、40.74%、66.67%),在12、13-20小時(shí)時(shí)間段進(jìn)食的患者并發(fā)急性肺損傷/肺纖維化、急性腎損傷的發(fā)生率最高(100.00%);12小時(shí)時(shí)間段進(jìn)食的患者并發(fā)急性肝損傷的發(fā)生率最高(100.00%);進(jìn)食時(shí)間對(duì)存活率的影響無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。急性百草枯中毒不同進(jìn)食時(shí)間對(duì)出現(xiàn)臟器損傷可能存在影響,治療過(guò)程中應(yīng)根據(jù)服毒量及時(shí)近一步分型,區(qū)分輕重程度,選擇合適的進(jìn)食時(shí)間,有可能改善預(yù)后。結(jié)論:1急性百草枯中毒總體病死率高,與服毒量相關(guān),爆發(fā)型預(yù)后不良,中-重型次之,輕型較好。2急性百草枯中毒不同進(jìn)食時(shí)間對(duì)出現(xiàn)臟器損傷可能存在影響,治療過(guò)程中應(yīng)根據(jù)服毒量及時(shí)近一步分型,區(qū)分輕重程度,選擇合適的進(jìn)食時(shí)間,有可能改善預(yù)后。3急性百草枯中毒患者合適的進(jìn)食時(shí)間尚需探討。
[Abstract]:Objective: to analyze retrospectively 254 patients with acute paraquat poisoning admitted to Cangzhou people's Hospital from January 2009 to September 2013 to understand whether eating food at different times has influence on the complications and prognosis of the patients. Methods: from January 2009 to September 2013, 254 cases of acute paraquat poisoning in emergency department of Cangzhou people's Hospital were collected retrospectively. According to the severity of the disease, the patients in the study were divided into three groups: 53 mild, 72 moderate and 129 fulminant. Each group was divided into 6 time periods according to different feeding time. The complications and prognosis of patients with different feeding time were statistically analyzed, including acute lung injury / pulmonary fibrosis, acute renal injury, acute liver injury and survival. The influence of different feeding time on the complications and prognosis was not statistically significant (P 0.05). However, 53 cases of mild patients were found after further classification, and the effect of different feeding time on the survival rate was significant (P 0.01). Among them, the survival rate of the patients who ate at 12 hours was the lowest (80.00000) and the survival rate was the highest at the time of 44 hours (100.000. 00g). The time of eating was associated with acute lung injury / pulmonary fibrosis and acute renal injury. There was no significant difference in the effect of acute liver injury on the survival rate, acute lung injury / pulmonary fibrosis and acute renal injury in 72 patients with moderate to severe liver injury (P 0.01). The survival rate of patients with acute lung injury / pulmonary fibrosis was the lowest in patients who took food at 120.13-20 hours and the highest survival rate was 71.43in 44 hours, and 28.5775 in patients with acute lung injury / pulmonary fibrosis during the period of 13-20 hours. The survival rate of patients with acute lung injury / pulmonary fibrosis was lower than that of patients with acute lung injury / pulmonary fibrosis in the period of 12-20 hours. The incidence of food intake was the highest (60.00g / kg); the incidence of acute renal injury was the lowest in patients who ate at 12 hours (33.33 / 37-43 hours); the incidence of acute liver injury was not significantly affected by different feeding time (57.14g / kg). There were 129 cases of outbreak type. The effect of different feeding time on the occurrence of acute lung injury / pulmonary fibrosis, acute renal injury and acute liver injury was statistically significant. The incidence of acute lung injury / pulmonary fibrosis, acute renal injury, and acute liver injury were the lowest in patients who ate at 44 hours (74.07, 74.07 and 40.74, 66.67, respectively), and those who ate at 1213-20 hours were complicated with acute lung injury / pulmonary fibrosis. The incidence of acute renal injury was the highest in the patients who ate at 100.00000 hours and had the highest incidence of acute liver injury. The effect of feeding time on survival rate was not statistically significant (P 0.05). Different feeding time of acute paraquat poisoning had significant effect on the occurrence of acute liver injury. Organ damage may have an effect, In the course of treatment, the prognosis may be improved according to the level of toxicity and the appropriate feeding time. Conclusion the overall fatality rate of acute paraquat poisoning at 1: 1 is high, which is related to the amount of poison taken, and the prognosis of outbreak type is poor. Mild paraquat poisoning with different feeding time may have an effect on visceral injury. In the course of treatment, it is necessary to select the appropriate feeding time according to the level of toxicity and the degree of severity. It is possible to improve the prognosis of 3. 3 patients with acute paraquat poisoning the appropriate feeding time needs to be explored.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R595.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 宋建民,王惠閣,李炳華,勾小華,盧瑞琦,楊澤峰;機(jī)械通氣治療急性百草枯中毒致呼吸衰竭12例臨床分析[J];國(guó)外醫(yī)學(xué).呼吸系統(tǒng)分冊(cè);2005年01期

2 薛維亮;胡峰;杜莉;;百草枯中毒機(jī)制與臨床治療的研究進(jìn)展[J];實(shí)用醫(yī)藥雜志;2010年02期

3 潘莉;劉媛媛;吳曉飛;;烏司他丁對(duì)急性百草枯中毒的療效觀察[J];中華全科醫(yī)學(xué);2012年08期

4 田英平;蘇建玲;高恒波;佟飛;陳慧;石漢文;霍書花;;113例百草枯中毒救治體會(huì)[J];中國(guó)急救醫(yī)學(xué);2006年07期

5 孫毅;;血液灌流在百草枯中毒中的應(yīng)用[J];中外醫(yī)學(xué)研究;2014年04期

6 李國(guó)強(qiáng);孫亮;李玉明;;血液凈化治療百草枯中毒的臨床研究進(jìn)展[J];中國(guó)醫(yī)學(xué)裝備;2014年06期

7 趙燕;程文偉;郝玉貴;;烏司他丁聯(lián)合血必凈注射液治療急性百草枯中毒的臨床研究[J];中國(guó)實(shí)用醫(yī)藥;2014年17期

，

本文編號(hào)：1503285