丙种球蛋白佐治有机磷杀虫药中毒致呼吸肌麻痹疗效观察

Observation of the effects of γ-globulins as an adjuvant on respiratory muscles paralysis caused by acute organophosphate poisoning.

目的 :观察丙种球蛋白辅助治疗急性有机磷杀虫药中毒致外周呼吸肌麻痹的临床效果。方法 :116例急性有机磷杀虫药中毒致呼吸肌麻痹患者随机分为实验组和对照组各 5 8例 ,两组患者基础治疗相同 ,试验组在此基础上加用丙种球蛋白 10 g/d静脉滴注 ,疗程 3日 ;比较两组疗效。 结果 :试验组痊愈率为 98% ,对照组痊愈率为 87% ,两组比较无统计学意义 (P >0 0 5 )。全血胆碱酯酶活力 :试验组治疗前后分别为 0 2 5± 0 0 9、 0 5 4± 0 12 ,对照组为 0 2 4± 0 0 9、 0 4 9± 0 12 ;两组治疗后胆碱酯酶水平均有所提高 (均为P <0 0 1) ,但两组的差异无统计学意义 (P >0 0 5 )。试验组的机械通气时间和住院时间较对照组缩短 (P <0 0 5和P <0 0 1) ,并发呼吸机相关肺炎发生率低于对照组 (17%比 5 9% ,P<0 0 1) ;且未发现严重不良反应。结论 :丙种球蛋白对急性有机磷杀虫药中毒致呼吸肌麻痹有治疗价值。

Objective: To observe the effects of γ-globulins as an a dj uvant on respiratory muscles paralysis caused by acute organophosphate poisoning . Methods: 116 patients with respiratory muscles paralysis caused b y acute organophosphate poisoning were randomly divided into two groups. Baseli ne treatments were similar in all patients. Patients in the experiment group we re additionally given γ-globulins 10 g intravenously per day for three days. Clinical effects of two groups were compared.Results: The differenc e in the rate of recovery between the two groups was not statistic significant ( P>0.05). After treatment the whole blood cholinesterase level in two groups became higher than baseline level(P<0.01, P<0.01), but th e difference of cholinesterase level between the two groups was not statistic s ignificant (P>0.05).The time of machine ventilation and duratio n of hospitalization in the experimental group were shorter than the matched con trol (P<0.05 and P<0.01), and its occurrence rate of ventilator-assoc iated pneumonia was lower than the matched control, too (P<0.01). No severe untoward reactions were found.Conclusion: γ-globulins plays a role in the treatment of respiratory muscles paralysis caused by acute o rganophosphate poisoning. [