目的 探讨改良洗胃法在急性中毒患者洗胃中的应用效果。 方法 将2010年1月－2012年2月收治的口服药物中毒需采用电动洗胃机洗胃的患者分为观察组和对照组，观察组采用改良洗胃法，对照组采用传统的洗胃方法，比较两组患者洗胃总时间、洗胃总液量、一次性插管成功率、堵管发生率及并发症发生率。 结果 观察组患者洗胃总时间低于对照组[（28.60 ± 6.32）、（34.51 ± 5.37）min]，洗胃总液量低于对照组[（10 856 ± 3 818）、（17 962 ± 3 855）mL]，差异有统计学意义（P＜0.001）；一次性插管成功率高于对照组（93.02% 、67.44%），差异有统计学意义（P=0.03）；堵管发生率为低于对照组（4.88%、27.91%），差异有统计学意义（P=0.03）；并发症发生率低于对照组（2.33%、37.21%），差异有统计学意义（P＜0.001）。 结论 改良洗胃法可减少洗胃总时间及洗胃液总量，提高一次性插管的成功率，同时可降低堵管及并发症的发生率。
ObjectiveTo explore the effects of small dose and low pressure lavage on gastrointestinal hemorrhage induced by acute poisoning. MethodsWe collected the clinical data of all the patients diagnosed as gastrointestinal hemorrhage induced by acute poisoning treated between January 2011 and December 2012. The patients were divided into two groups: control group and treatment group, according to the different treatments they underwent. The control group received traditional treatment only, while the treatment group received small dose and low pressure lavage as well as the traditional treatment. After recording the ages, poisoning dose, pretreatment time, shock and complications, we evaluated the risk of death by calculating ROCKALL scores. ResultsThe differences of ages, sexes, and poisoning dose between these two groups were not significant. However, the death rate in high and middle risk patients of the treatment group was significantly lower than that of the control group (P<0.05). ConclusionThe small dose and low pressure lavage can improve the prognosis of the gastrointestinal hemorrhage induced by acute intoxication.
Acute poisoning is characterized by a sudden and rapid onset, most poisons lack specific antidotes. Even with the full use of blood purification, mechanical ventilation, and various drugs, it is often difficult to change the fatal outcome of critically ill patients. In recent years, extracorporeal membrane oxygenation (ECMO) has gradually gained attention and exploratory application in the treatment of acute poisoning due to its significant cardiopulmonary function support, veno-venous ECMO is used for severe lung injury after poisoning, acute respiratory distress syndrome and respiratory failure due to ineffective mechanical ventilation, and it can also be used to assist the removal of residual poisons in the lungs. Veno-arterial ECMO is commonly employed in patients with circulatory failure following poisoning, fatal cardiac arrhythmias, and arrest of cardiac and respiratory. The application of veno-arterio-venous ECMO has also been reported. The mode of ECMO necessitates timely adjustments according to the evolving illness, while ongoing exploration of additional clinical indications is underway. This review analyzes and evaluates the application scope and effectiveness of ECMO in acute poisoning in recent years, with a view to better exploring and rationalizing the use of this technology.