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目的:观察机械通气在救治毒鼠强中毒患者时的应用效果。方法:对24例急性毒鼠强中毒患者均在确诊后,立即鼻气管插管建立人工气道,然后经口插胃管洗胃。如持续抽搐,在应用肌松剂持续静脉泵注的同时,立即给以机械通气进行呼吸支持,并动态监测机械通气前和机械通气后30分钟、1小时、12小时、24小时、48小时和脱机前动脉血气。通过统计学分析比较不同时期的动脉血气分析结果。同时统计其救治成功率。结果:所有患者在机械通气12小时后,低氧血症均有不同的程度的改善。所有患者在机械通气后48小时动脉血气各指标均恢复正常。与上机前比均有非常显著性差异(P<0.01)。结论:对于急性毒鼠强中毒患者的病因治疗虽至关重要,但控制持续抽搐和呼吸功能的支持和监测是预后的关键。因此,尽早建立人工气道,在出现持续抽搐时应用肌肉松弛剂的同时应用机械通气,能有效控制抽搐,有利于防治因持续抽搐所致低氧和急性呼吸功能不全引发的多脏器功能障碍综合征(MODS)。
Objective: To observe the effect of mechanical ventilation in the treatment of tetramine poisoning patients. Methods: Twenty-four patients with acute tetramine poisoning were diagnosed immediately after nasal endotracheal intubation to establish artificial airway, and gastric lavage by gastric intubation. If sustained convulsions, continuous intravenous muscle relaxant application with simultaneous mechanical ventilation for respiratory support and dynamic monitoring of mechanical ventilation and mechanical ventilation 30 minutes, 1 hour, 12 hours, 24 hours, 48 hours and Off-line arterial blood gas. The results of arterial blood gas analysis in different periods were compared by statistical analysis. At the same time statistics of the success rate of treatment. RESULTS: Hypoxemia was improved to varying degrees in all patients 12 hours after mechanical ventilation. All patients returned to normal at 48 hours after mechanical ventilation. Compared with before the machine has a very significant difference (P <0.01). CONCLUSIONS: Although the etiological treatment of patients with acute tetramine poisoning is crucial, support for and monitoring of persistent convulsions and respiratory function are key prognostic factors. Therefore, the establishment of artificial airway as soon as possible, the application of muscle relaxants in the event of persistent convulsions while mechanical ventilation, can effectively control convulsions, is conducive to the prevention and treatment of persistent organ failure due to hypoxemia and acute respiratory insufficiency caused by multiple organ dysfunction Syndrome (MODS).