改良应用解毒药物治疗有机磷中毒时的病情观察

The nursing of the rational use of alexipharmic to acute organic phosphorus poisoning patients

目的探讨改良应用解毒药物治疗有机磷中毒时的病情观察方法，以提高治愈率。方法观察组患者426例采用新方法治疗，即使用阿托品快速消除中毒症状后停药观察，待再出现轻微中毒症状时再次应用阿托品，氯磷定仅应用1～2d；对照组患者470例采用传统治疗方法，即达到传统阿托品化标准后维持一段时间，逐渐减量，直至停用阿托品。收集两组氯磷定和阿托品应用时间、应用总量、住院天数和不良反应等资料，并对两组资料进行统计学分析。结果观察组几乎无尿潴留、烦躁不安和呼吸衰竭等不良反应的发生，解毒药物的应用时间及总量亦明显少于对照组，大部分患者24h即可不再应用解毒药物且经观察无反跳病例发生。结论认真观察病情变化、及时合理调整解毒药物的应用，能明显提高治愈率、缩短住院时间、减少过量应用阿托品及氯磷定造成的毒副反应。

Objective To explore the nursing of the rational use of alexipharmic to acute organic phosphorus poisoning （AOPP） patients, and rise the healing rate of AOPP. Methods A total of 426 cases of the new treatment group were given atropine to Atropinization rapidly and given atropine again only when minimal atropine poisoning occurs. Pralidoxime Chloride （PAM - C1） only was prescribed for 1 - 2 days. The control group was given the classic treatment of AOPP. ie. continue given a fixed dose of atropine for several days after reaching the atropinization , and reduce the dose of atropine gradually , and till to stop it. The data of the total dose of PAM - C1 and atropine , the length of stay and untoward effect were compared. Results There were fewer cases occurring uroshesis , dysphasia and respiratory failure in observation group, and the total dose of PAM - C1 was less than that of the control group. , there are fewer cases appear rebound after withdrawing PAM - C1 in 24 hours. Conclusions The nursing timely and new treatment to AOPP may magnificently rise the healing rate of AOPP, cut down the length of stay, reduce the incidences of over dose of PAM - Ci and atropine.