全血胆碱酯酶含量对有机磷中毒患者并发呼吸衰竭时治疗的影响分析

目的探讨在有机磷中毒患者并发呼吸衰竭治疗中全血胆碱酯酶含量和机械通气时间、阿托品用量的关系。方法对我院收治的有机磷农药中毒并发呼吸衰竭47例患者的治疗过程进行监测，在气管插管前、停用机械通气时、拔除气管插管时，分别测定胆碱酯酶（ChE）、血氧分压（PaO2）的变化，同时记录阿托品的用量。结果呼吸衰竭时，ChE、PaO2极低，此时需机械通气治疗，阿托品用量较大；当ChE恢复至正常值的60％左右时，患者肌力部分恢复，可停用机械通气和阿托品治疗，与机械通气前比较，有统计学意义（P〈0．01）；拔除气管插管时，ChE、PaO2显著升高，与机械通气前比较，有统计学意义（P〈0．01），但与停用机械通气时比较，无统计学意义（P〉0．05）。结论有机磷农药中毒伴呼吸衰竭时，ChE、PaO2极低，必须机械通气支持；当ChE恢复至正常值60％左右时，可停用机械通气和阿托品治疗，观察24h，病情未反复，可拔除气管插管。

Analysis on the effect of blood cholinesterase in patients with severe organic phosphorus intoxication combined with the respiratory failure

Objective To research the relationship among the blood cholinesterase mechanical ventilation time,and dosage of atropine in patients with severe organic phosphorus intoxication combined with the respiratory failure.Methods 47 patients with severe organic phosphorus intoxication combined with the respiratory failure were monitored before tracheal intubation,ceasing mechanical ventilation time,and tracheal intubation pulled out while measuring the change of ChE and PaO2,and recording the volume of atropine.Re...