重度有机磷农药中毒救治方法的改进

New Improvement of treatment for severe acute organophosphorus pesticides poisoning

目的 探讨提高急性重度有机磷农药中毒（ＳＡＯＰＰ） 抢救成功率的新方法。方法 将我院１９９２ 年８ 月～１９９８ 年６ 月收治的１０８ 例ＳＡＯＰＰ 患者随机分为２ 组：新法治疗组采用：（１） 在抢救程序方面，先注射解毒剂和拮抗剂，再清除毒物（ 洗胃或清洗皮肤，或边治疗边清除毒物；（２） 保留胃管反复洗胃；（３） 病人进入ＩＣＵ 病房全程监护的新方案给以处理治疗。对照组按先洗胃后注射解毒剂及收住普通病房的常规方法处理及治疗。结果 治疗组与对照组疗效出现时间及达到阿托品化时间分别为（１４ ．０ ±２ ．５） 分钟、（３２ ．５ ±５ ．１） 分钟和（３ ．５ ±１ ．２） 小时、（６ ．３ ±４ ．５） 小时；反跳例数及死亡数分别为４例、１１ 例及３ 例（４ ．７ ％ ） ，１２ 例（２７ ．２ ％ ）（ Ｐ＜ ０ ．０１） 。结论 新改进的方法对提高ＳＡＯＰＰ

Objective To compare the efficacy between two kinds of treatment for severe acute organophosphorus pesticides poisoning(SAOPP).Methods 108 cases of SAOPP who were treated in August 1992～June 1998 were randomly divided into new treatment group A and conventional treatment group B.Patients in group A were treated by injection of antidotes before or with silmutaneous gastric lavage or retention of gastric tube for washing stomach repeatedly,then kept the patients in ICU ward.Patients in group B were treated with conventional methods,first by gastric lavage,followed by antidotes injection.Results The initial therapeutic effects and atropinization appeared at (14.0±2.5)min and (3.5±1.2)h respectively in group A,whereas (32.5+5.1)min and (6.3±4.5)h respectively in group B.The number of recurrence and death was 4 and 3(4.7%) in group A,11 and 12(27.2%) in group B respectively( P <0.01).Conclusion The new method significantly improved the efficacy of emergency treatment for SAOPP.