急性敌敌畏中毒合并急性乙醇中毒患者胰腺损害的临床研究

目的探讨急性敌敌畏中毒合并急性乙醇中毒患者重症胰腺炎发生情况,以指导临床早期诊断和合理治疗。方法将就诊于河北大学附属医院急诊科的140例急性重度敌敌畏中毒患者分为单纯敌敌畏中毒组(80例)、敌敌畏中毒合并乙醇中毒组(60例);于入院后24 h内通过血尿中淀粉酶、胰腺CT检查明确胰腺炎诊断;对2组患者胰腺炎发生率及其预后进行比较。结果急性敌敌畏中毒合并急性乙醇中毒患者20例发生重症胰腺炎,单纯敌敌畏中毒组14例发生重症胰腺炎,两组差异有统计学意义(χ2=4.67,P0.05);混合中毒组胰腺炎患者并发症发生率、手术率、病死率、住院时间均高于单纯敌敌畏中毒组。结论与单纯敌敌畏中毒相比,急性敌敌畏中毒合并急性乙醇中毒患者更易发生重症胰腺炎,其病死率高,预后差。

Clinical study on pancreatic damage in patients with acute dichlorvos poisoning combined with alcohol poisoning

Objective]To investigate the incidence rate of severe pancreatic damage in patients with acute dichlorvos poisoning combined with alcohol poisoning,in order to guide the clinical early diagnosis and rational treatment.Methods]140 acute dichlorvos poisoning cases in Emergency Department of Affiliated Hospital of Hebei University were divided into dichlorvos poisoning group（80 cases） and dichlorvos poisoning combined with alcohol poisoning group（60 cases）.The acute pancreatitis was diagnosed through blood and urine amylase detection,and pancreatic CT within 24 hours after admission.The pancreatitis incidence and prognosis of two groups were compared.Results] There was 20 severe acute pancreatitis cases in dichlorvos poisoning combined with alcohol poisoning group and 14 cases in dichlorvos poisoning group,and the difference between two groups was significant（χ2=4.67,P0.05）.The incidence rate of complications,operation rate,mortality rate and hospitalization time in dichlorvos poisoning combined with alcohol poisoning group were higher than those in dichlorvos poisoning group（P0.05）.Conclusion]Compared with single dichlorvos poisoning group,there is a higher incidence rate of severe pancreatitis in dichlorvos poisoning combined with alcohol poisoning group,and it has high mortality rate and poor prognosis.