重症监护谵妄筛查评分在急性有机磷农药中毒救治中的应用

摘要

[Objective]To define the effects of intensive care delirium screening checklist(ICDSC)on deliri-um caused by penehyclidine hydrochloride in patients with acute organophosphorus poisoning(AOPP).[Meth-ods]One hundred and twenty cases of acute organophosphorus poisoning patients from May,201 1 to August , 2014 were randomly assigned into two groups:controlled group,treated with penehyclidine hydrochloride as regular (n =62)and observed group,treated with penehyclidine hydrochloride guided by ICDSC (n =58). Then according to the degree of poisoning ,the two groups were respectively divided into light,middle,and severe subgroups.The start of delirium ,the degree and duration of delirium,the disappear time of muscarinic symptoms,the recovery time of cholinesterase and duration of the hospital staying were analyzed.[Results]The observed group had significantly improvement in the duration of time and the degree of delirium compared to the controlled group for middle and severe subgroups (P <0.05),the hospital stays of the observed group is shorter significantly (P <0.05),while the two groups had no difference in cure rate(P >0.05).[Conclu-sion]When treat acute organophosphorus poisoning patients,the dosage of penehyclidine hydrochloride,the de-gree of delirium and the duration of hospital stay can be reduced guided by ICDSC.%【目的】明确重症监护谵妄筛查评分(ICDSC)在治疗急性有机磷农药中毒(AOPP)患者时,对盐酸戊乙奎醚(长托宁)相关药源性谵妄的影响。【方法】选择2011年5月至2014年8月本院收治的120例 AOPP 患者,随机分为对照组(n=62,给予常规长托宁治疗)和观察组(n=58,ICDSC 谵妄评分指导下的给予长托宁治疗)。分析比较两组患者谵妄出现时间及持续时间、谵妄的分值,并记录患者毒蕈碱样(M)症状消失时间、胆碱酯酶恢复时间及住院时间。【结果】观察组中度和重度中毒患者谵妄持续时间、谵妄程度与对照组相比均有明显改善(P <0.05),并且住院时间缩短(P <0.05),而两组的治愈率无明显差别(P >0.05)。【结论】治疗AOPP 时,采用 ICDSC 评分系统可以减少长托宁的用量,降低谵妄的严重程度,缩短患者的住院时间。