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頁籤選單縮合
題名 | Prognostic Factors of Organophosphate Poisoning between the Death and Survival Groups=有機磷中毒個案死亡和存活者之預後因素 |
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作者姓名(中文) | 林增記; 江大雄; 陳漢文; 洪東榮; 李宏萍; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 23:4 2007.04[民96.04] |
頁次 | 頁176-182 |
分類號 | 418.733 |
關鍵詞 | 乙醯膽鹼酯酶; 死亡率; 有機磷; 血漿膽鹼酯酶; 預後; Acetylcholinesterase; Mortality; Organophosphate; Plasma cholinesterase; Prognosis; |
語文 | 英文(English) |
中文摘要 | 我們的研究目的是比較有機磷中毒時死亡者和存活者之差異,在前瞻性連續個案收集之研究,將三級教學醫院有機磷中毒個案收錄在本研究中,當臨床狀況被控制後先停止阿托平,然後再停止巴姆。我們記錄人口統計學的資料、有機磷服食量、昏迷期間、呼吸器使用期間、住院期間、胸部 X 光發現、白血球記數、乙醯膽鹼酯酶濃度、血漿膽鹼酯酶濃度、阿托平使用總量、阿托平使用期間、巴姆使用總量、巴姆使用期間、尿液最高有機磷濃度、尿液有機磷出現期間和死亡案例,並且每八小時紀錄尿液,用氣相層析法火焰光度偵測法和氣相層析法質譜法等檢測尿液有機磷,並記錄尿液有機磷最高濃度。統計上使用 Wilcoxon rank sum test 來比較死亡及存活族群之各種項目,Fisher’s exact test 被用來比較兩組胸部 X 光發現。結果為死亡組比存活組有較高的有機磷服食量、白血球記數和昏迷期間;有較低的住院期間、乙醯膽鹼酯酶濃度、血漿膽鹼酯酶濃度、巴姆使用總量和巴姆使用期間;但胸部 X 光發現、呼吸器使用期間、阿托平使用總量、阿托平使用期、尿液最高有機磷濃度和尿液有機磷出現濃度則無明顯的差別,死亡率為 20%。死亡組似乎沒有足量的巴姆治療,雖然死亡組及存活組巴姆使用期間的中位數比尿液有機磷出現期間的中位數高,但是巴姆使用期間的最大值小於尿液有機磷出現期間的最大值。長期的昏迷、低的乙醯膽鹼酯酶濃度及血漿膽鹼酯酶濃度和病人的臨床惡化結果有顯著之關係。 |
英文摘要 | In this prospective case series study, we consider the different factors between death and survival groups of organophosphate poisoning. Patients in tertiary-care medical center who had been exposed to organophosphate were included in the study. Pralidoxime (PAM) was discontinued after atropine had controlled the clinical situation. We recorded the demographic data, amount of organophosphate consumption, duration of coma, duration of ventilator use, duration of hospitalization, findings of chest X-ray, white blood cell count, acetylcholinesterase concentration, plasma cholinesterase concentration, total atropine amount, duration of atropine use, total PAM amount, duration of PAM use, urine organophosphate peak concentration, duration of urine organophosphate and mortality rate. Urine was collected every 8 hours and was analyzed by gas chromatography equipped with a flame photometric detector and gas chromatography with mass spectrometer detector for organophosphate determination. The urine organophosphate peak concentration was recorded. Wilcoxon rank sum test was used to compare the factors between death and survival groups. Fisher’s exact test was used to compare the different findings of chest X-ray between the death and survival groups. Evidently, the death group had a higher amount of organophosphate consumption, duration of coma, and higher white blood cell count than those in the survival group. Also, the death group had lower duration of hospitalization, and decreased concentrations of acetylcholinesterase and plasma cholinesterase. Total PAM amount use and duration of PAM use were lower. However, the duration of ventilator use, findings of chest X-ray, total atropine amount, duration of atropine, urine organophosphate peak concentration and duration of urine organophosphate were similar in both groups. The mortality rate of our 50 cases was 20%. As stated earlier, the cases of the death group had insufficient PAM therapy. The maximum duration of PAM use was shorter than the maximum duration of urine organophosphate, although the medians of duration of PAM use were more than the medians of duration of urine organophosphate in both the survival and death groups. Prolonged coma duration, lower level of acetylcholinesterase and lower level of plasma cholinesterase were related to the poor prognosis of the patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。