目的：探讨脂肪乳在急性有机磷农药中毒肺损伤中的应用价值。方法将36例急性有机磷农药中毒患者随机分为对照组(20例)和治疗组(16例)。对照组患者行彻底洗胃、长托宁和氯解磷定解毒、血液净化及机械通气等治疗，治疗组患者在对照组治疗基础上静脉滴注20％脂肪乳250 mL∕d，连用3 d。观察两组患者的氧合指数、抢救成功率、治愈好转率及平均住院时间等指标。结果治疗组患者的24 h氧合指数和治愈好转率明显高于对照组，平均住院时间比对照组长；重度中毒患者机械通气治疗比例明显低于对照组，差异有统计学意义（ P﹤0．05）；两组的抢救成功率比较，差异无统计学意义（ P﹥0．05）。结论脂肪乳能减轻急性有机磷农药中毒患者的肺损伤，降低重度中毒患者机械通气使用率，提高治愈好转率，具有较好的临床应用价值。%Objective To investigate the application value of fat emulsion supply for lung injury of acute organophosphorus pesticide poisoning. Methods 36 acute organophosphorus pesticide poisoning patients were randomly divided into two groups. 20 cases in the control group were treated with completely gastric lavage,penehyclidine hydrochloride,pralidoxime chloride,hemopurification and mechani-cal ventilation. 20% concentration of fat emulsion (250 mL per day) was provided 3 d among the other 16 cases in the treatment group on the basis of the control group treatment. Difference of the oxygenation index,success rate of rescue,cure and improvement rate and total hospital stay between two groups were observed. Results The 24 h oxygenation index and the cure and improvement rate in the treatment group was significantly higher than that in the control group;the percentage of mechanical ventilation application in the treatment group was lower than the control group among severe poisoning patients. However,the average hospital stay of control group was shorter than that of the treatment group( P ﹤ 0. 05)and the success rate of rescue between two groups did not show statistical differences ( P ﹥ 0. 05). Conclusion The therapy of fat emulsion supply in the acute organophosphorus pesticide poisoning could re-duce lung injury,reduce the application of mechanical ventilation in severe poisoning patients,increase the cure and improvement rate and has good clinical effect.
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