摘要目的 探讨急性有机磷中毒(AOPP)患者的预后相关因素,以期寻求客观评价急性有机磷中毒(AOPP)患者预后的方法,提高抢救成功率.方法 回顾性分析自2006年4月至2014年3月我院急诊科收治的116例急性有机磷中毒患者.根据患者治疗结果分死亡组与生存组,对两组患者临床资料,采用logistic回归分析其预后相关因素.结果 116例急性有机磷中毒患者中死亡23例,好转93例.死亡组APACHE-Ⅱ评分高于生存组(P＜0.05).与生存组相比,死亡组患者体温、血压、pH、GCS降低,差异有统计学意义(P＜0.05),血钠、肌酐、白细胞计数、谷氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酸激酶同工酶(CK-MB)、血糖、血乳酸、心率等指标升高,差异有统计学意义(P＜0.05).其中低血压、低GCS评分、高血糖和高白细胞计数是预后不良的独立风险因素,且低血压与预后不良相关性大(OR=54.22).结论 APACHE-Ⅱ评分系统可较准确地反应预后,生命体征、白细胞计数、pH、血肌酐及GCS评分、血钠值可能与预后相关.ALT、AST、CK-MB的升高对评估病情的严重程度及预后也有一定的价值.

abstractsObjective To find out a method which can assess the prognosis of patients with Acute Organophosphate Poisoning objectively and increase the successful ratio of treatment by investigating relevant factors on the prognosis of the patients with Acute Organophosphate Poisoning.Methods We retrospected 116 patients with Acute Organophosphate Poisoning who were treated in our hospital's emergency room from April 2006 to March 2014.According to the outcome of patients,we distributed the patients to death group and survival group,compared the clinic data and using multivariate analysis with Logistic regression to prognosis factors.Results 116 cases of acute organophosphate poisoning patients died in 23 cases,improved in 93 cases.Death group patients' APACHE-Ⅱ score are higher than whose in the survival group(P＜0.05).Compared with the survival group,patients' body temperature,blood pressure,pH,GCS index were lower in the death group (P＜0.05) and Cr,WBC,ALT,AST,CK-MB,blood glucose,blood lactic acid,heart rate were higher in the death group (P＜0.05),there were significant difference between two groups with statistical.Low blood pressure,lower GCS score,hyperglycemia and high white blood cell count,were independent risk factors of poor prognosis,and hypotension was maximum value of all the factor (OR =54.22).Conclusion APACHE Ⅱ prognostic scoring system can be accurately response,vital signs,white blood cell count,pH,serum creatinine,GCS score and serum sodium value which in this system may be associated with prognosis.To evaluate the severity and prognosis of illness Blood glucose,ALT,AST,CK-MB's rising also has certain value.