Abstract
Objective To investigate the effect of volume load management on prognosis in elderly patients with severe organic phospho-rus poisoning. Methods 120 elderly patients with severe organic phosphorus poisoning treated between August 2013 and August 2015 were selected, and randomly divided into observation group ( n=60 ) and control group ( n=60 ) . After admission, the observation group re-ceived target management with daily infusion quantity under the treatment plan of detoxification by atropine and reactivation by prali-doxime chloride;while the control group underwent no strict transfusion balance management under the same treatment plan. At 5 d after the treatment, biochemical indicators, including creatine kinase isoenzyme ( CK-MB ) , troponin ( cTnI ) , plasma B-type natriuretic peptide ( BNP ) , serum creatinine ( Scr ) and glutamic-oxalacetic transaminase ( AST ) levels, of the patients between the two groups were com-pared. In addition, utilization rate of mechanical ventilation, mechanical ventilation duration, incidence of pulmonary infection, incidence of multiple organ failure and clinical case-fatality rate of the patients in the two groups were analyzed. Results Before the treatment, there was no statistical significance in baseline data, such as age, gender, poison type, toxic dose or basic medical history between the patients in the two groups ( P > 0. 05 ) . After the treatment, the comparison between the observation group and the control group revealed that CK-MB, cTnI, BNP and AST of the patients in the observation group reduced significantly, with statistical significance between the two groups [ CK-MB: ( 32. 76 ± 8. 37 ) U/L vs. ( 54. 61 ± 8. 90 ) U/L, t=2. 986;cTnI: ( 0. 95 ± 0. 15 ) ng/mL vs. ( 1. 38 ± 0. 23 ) ng/mL, t=3. 012; BNP: ( 895. 18 ± 62. 10 ) pg/mL vs. ( 2 097. 17 ± 59. 27 ) pg/mL, t=3. 052; Scr: ( 126. 90 ± 23. 51 )μmol/L vs. ( 187. 58 ± 30. 85 )μmol/L, t=2. 891;AST: ( 48. 09 ± 10. 95 ) U/L vs. ( 86. 90 ± 11. 46 ) U/L, t=2. 699, respectively, P < 0. 05 ] . Additionally, clinical indica-tors showed that utilization rate of mechanical ventilation [ ( 34/60, 56. 67%) vs. ( 35/60, 58. 33%) , χ2= 2. 871 ] , mechanical ventilation duration [ ( 3. 87 ± 1. 05 ) d vs. ( 5. 38 ± 1. 36 ) d, t=2. 906 ) , incidence of pulmonary infection [ ( 9/60, 15. 00% ) vs. ( 23/60, 38. 33% ) ,χ2=2. 898 ] , incidence of multiple organ failure [ ( 15/60, 25. 00% ) vs. ( 37/60, 61. 67% ) , χ2=3. 096 ] , and clinical case-fatality rate [ ( 7/60, 11. 67%) vs. ( 13/60, 21. 67%) , χ2=3. 018 ] in the observation group decreased apparently as compared to the control group, which presented statistical significance between the two groups ( P < 0. 05 ) . Conclusion Strict target management of volume load for el-derly patients with severe organic phosphorus poisoning is helpful to effectively decrease multiple organ dysfunction, incidence of compli-cations and case-fatality rate in patients.关键词
老年/有机磷中毒/重症/预后Key words
elderly/organic phosphorus poisoning/severe/prognosis分类
医药卫生
