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目的总结有机磷农药中毒气管插管患者非计划性拔管(Unplanned extubation,UE)的发生率,分析UE发生的相关原因。方法回顾性分析2009年1月至2010年12月我科收治的43例有机磷农药中毒气管插管患者年龄、性别、Ramsay评分、阿托品日平均用量、气道痰痂评分、使用气管导管型号等临床资料,评估UE发生率并筛查UE的临床危险因素。结果本组有机磷农药中毒气管插患者UE发生率为30.23%,单因素分析显示,UE组与非UE组Ramsay评分、阿托品日平均用量及气道痰痂评分差异有统计学意义,Logistics逐步回归分析显示Ramsay评分(OR=0.079)和气道痰痂评分(OR=7.029)与UE的发生独立相关。结论有机磷农药中毒气管插患者UE发生率较高,Ramsay评分低和气道痰痂评分高是发生UE的独立危险因素。有效镇静和强化气道管理可能有助于减少UE的发生,提高有机磷农药中毒患者的救治成功率。
OBJECTIVE: To summarize the incidence of unplanned extubation (UE) in patients with organophosphorus pesticide poisoning after endotracheal intubation and to analyze the related causes of UE. Methods Retrospective analysis of 43 patients with organophosphorus pesticide poisoning endotracheal intubation in our department from January 2009 to December 2010 retrospectively analyzed the age, gender, Ramsay score, daily average atropine dosage, sputum calyx score of airway, tracheal tube type, etc. Clinical data, assessment of UE incidence and screening of UE clinical risk factors. Results The incidence of UE in organophosphorus pesticide poisoning patients was 30.23%. Univariate analysis showed that Ramsay score, atropine daily average dosage and sputum calyx score in UE group and non-UE group were significantly different Analysis showed that Ramsay score (OR = 0.079) and airway sputum scab score (OR = 7.029) were independently associated with the occurrence of UE. Conclusion The incidence of UE in organophosphorus pesticide poisoning patients with high incidence of UE, low Ramsay score and sputum scoring of the airway is an independent risk factor for UE. Effective sedation and enhanced airway management may help reduce the incidence of UE and improve the success rate of treatment of organophosphorus pesticide poisoning patients.