优化护理模式抢救重度有机磷中毒的效果

目的通过优化护理模式,观察重度有机磷中毒抢救的临床效果。方法选取2007年10月～2013年5月右江民族医学院附属医院急诊科抢救的重度有机磷农药中毒患者128例为研究对象,按就诊时间不同,将2010年8月～2013年5月66例患者作为观察组,将2007年10月～2010年7月62例患者作为对照组。两组患者均采取洗胃、补液、应用解毒药、血液净化等抢救治疗。对照组给予常规急救护理方法救治,观察组给予优化急救护理模式救治。分析观察比较两组48 h抢救内患者的意识、生命体征、临床症状、全血胆碱酯酶活性、重要器官功能、临床疗效（用解毒药时间、住院时间、治愈出院率、并发症发生率、病死率）及护理满意度。结果观察组患者48 h抢救内,生命体征平稳（2.56±0.50）分]、意识恢复（2.30±0.69）分]、临床中毒症状消失（2.44±0.62）分]、全血胆碱酯酶活性≥70%（2.36±0.82）分]及重要器官功能无损害（2.06±0.63）分]得分均优于对照组（2.26±0.70）、（1.66±0.75）、（1.95±0.75）、（1.81±0.81）、（1.65±0.75）分],差异均有统计学意义（均P〈0.05）;用解毒药时间（5.21±0.71）d]及住急诊监护室时间（4.48±1.17）d]均明显短于对照组（7.71±0.78）、（6.81±1.52）d],差异均有统计学意义（均P〈0.05）;治愈出院率（95.5%）高于对照组（72.6%）,差异有统计学意义（x^2=12.687,P〈0.05）;并发症发生率（9.0%）低于对照组（22.6%）,差异有统计学意义（x^2=4.413,P〈0.05）;病死率（3.0%）低于对照组（14.5%）,差异有统计学意义（x^2=5.369,P〈0.05）。观察组护士在抢救过程的人员调配（2.52±0.66）分]、物品准备（2.76±0.43）分]、措施及时（2.83±0.38）分]、主动配合（2.61±0.49）分]、应急能力（2.88±0.33）分]、护理质量（2.91±0.29）分]、工作场景（2.73±0.45）分]评分与对照组（1.97±0.83）、（2.

Effect of optimization model of nursing care in the rescue of acute severe organophosphorus pesticide poisoning

Objective To study the clinical effect of the rescue in severe organophosphorus poisoning by optimizing model of nursing care. Methods 128 cases of patients with acute severe organophosphorus pesticide poisoning from October 2007 to May 2013 in the Department of Emergency, the Affiliated Hospital of Youjiang Medical College For Nationalities were randomly selected as the research objects. According to the different treatment time, 66 cases of patients from August 2010 to May 2013 were chosen as the observation group, while 62 cases from October 2007 to July2010 were chosen as the control group. The two groups were given the identical treatments including： gastric lavage, fluid infusion, application of antidote, blood purification and other life-saving treatment. The control group were given conventional method emergency nursing, and the observation group were given optimization of emergency nursing. The patient＇s consciousness, vital signs, clinical symptoms, blood cholinesterase activity, an important organ function, clinical efficacy（time of use alexipharmic, hospitalization time, cured rate, complications rate, mortality） and nursing satisfaction of the two groups were observed and analyzed within 48 hours. Results In the observation group, the quantity of the patients with stable vital signs within the rescue （2.56±0.50） scores], recovery of consciousness （2.30±0.69） scores],clinical symptoms disappeared （2.44±0.62） scores], whole blood cholinesterase activity ≥70% （2.36±0.82） scores] and no damage to vital organs function scoring （2.06±0.63） scores] were better than those of the control group （2.26±0.70）,（1.66 ±0.75）,（1.95 ±0.75）,（1.81 ±0.81）,（1.65 ±0.75）scores] respectively, and the differences were statistically significant（P 〈0.05）. The time of use alexipharmic （5.21±0.71） d] and live in emergency intensive care unit （4.48 ±1.17） d] were significantly shorter than the control group （7.71±0.78）,（6.81±1.52） d], an