活性炭和甘露醇联合应用对急性有机磷农药中毒的疗效

Effect of joint of activated charcoal and mannitol on the efficacy of treating acute organophosphorus pesticide poisoning

目的 探讨口服活性炭和甘露醇对急性有机磷农药中毒（AOPP）的毒物清除作用.方法 2004年1月至2009年12月南昌大学第一附属医院收治的41例重症AOPP患者随机分为试验组（活性炭吸附毒物和甘露醇导泻治疗组,n=21）和对照组（未用活性炭吸附毒物和甘露醇导泻治疗组,n=20）.两组患者均进行AOPP急救常规治疗,观察两组患者阿托品化时间、抢救成功率和住院时间的差异.结果 试验组阿托品化时间、抢救成功率和住院时间与对照组比较差异[（3.60±1.6）h vs.（17.5±13.4）h;（4.1±1.45）d vs.（8.00±2.13）d;100% vs.（70.0±4.7）]均有统计学意义（P＜0.01）.结论 活性炭和甘露醇联合应用较传统洗胃法更能有效清除进入体内的有机磷农药,且能缩短患者阿托品化时间和住院时间,进一步提高AOPP的抢救成功率,改善患者预后.

Objective To study the effect of oral administration of activated charcoal and mannitol on removing toxicant after acute organophosphorus pesticide poisoning （AOPP）. Method A total of 41 patients with severe AOPP were randomly divided into experiment group （activated charcoal used as adsorbent and mannitol used as cathartics, n =21）and control group （without adsorbent and cathartics, n = 20）. Patients of both groups received routine treatment for AOPP after admission to hospital. The differences in duration of atropinization, the length of hospitalization and the success rate of treatment were compared between two groups. Results There were significant differences in duration of atropinization, the success rate of treatment and hospitalization time between the two groups. Conclusions The combination of activated charcoal and mannitol is more effective than the conventional gastric lavage on removal of organophosphorus pesticides from G-I tract, shorting the duration of atropinization time and hospital stays, and enhancing the success rate of rescue as well as improving the outcome of patients after organophosphorus pesticide poisoning.