热毒宁注射液辅助治疗急性有机磷农药中毒并发呼吸机相关肺炎的疗效观察

Observation on Effect of Reduning Injection on Adjuvant Treatment for Acute Organophosphorus Pesticide Poisoning Complicated With Ventilator Associated Pneumonia

[目的]观察热毒宁注射液辅助治疗急性有机磷农药中毒(AOPP)致呼吸肌麻痹(RMP)并发呼吸机相关肺炎(VAP)的临床效果。[方法]将患者90例随机分为治疗组和对照组,两组患者均给予洗胃、导泻等常规处理,阿托品化、病情稳定后改用长托宁维持,早期、足量使用胆碱酯酶复能剂;出现RMP后,立即建立人工气道并进行机械通气治疗。VAP治疗:两组均给予头孢哌酮钠舒巴坦钠(2∶1)2.25 g加入生理盐水100 ml中静脉滴注,每6 h 1次,疗程10天;治疗组在此基础上加用热毒宁注射液20 ml加入5%葡萄糖注射液250 ml中静脉滴注,每天1次,疗程10天。[结果]治疗组疗效及在改善患者临床症状方面明显优于对照组(P<0.05),细菌的清除率两组比较无统计学意义,药物未见明显不良反应。[结论]热毒宁注射液是一种安全有效的治疗AOPP致RMP并发VAP的辅助药物。

[Objective] To observe clinical effects of reduning injection on adjuvant treatment for respiratory muscle paralysis （RMP） complicated with ventilator associated pneumonia （VAP） caused by acute organophosphorus pesticide poisoning （AOPP）. [ Methods ] Ninety patients were randomly divided into treatment group and control group. Routine treatment of gastric lavage and catharsis was given; penehyclidine hydrochloride injection was given after atropinization and patients＇ condition becoming stable, as well as early full cholinesterase reactivators. Artificial airway and mechanical ventilation therapy were immediately applied with appearance of RMP. For VAP, intravenous injection of cefoperazone sodium and sulbactam sodium （2：1）2.25 g ＋ normal saline 100 ml was given every 6 h, and the dedication lasted for 10 d. The above treatment was given to both groups. Based on this, reduning injection 20 ml and 5% glucose injection 250 ml were added to treatment group once a day, iv, drip, for 10 d. [ Results ] Therapeutic effect and symptom improvement in treatment group were significantly better than those in control group（P 〈0.05）. There was no statistically significant effect on bacterial clearance between two groups. Marked adverse reaction of drug was not observed, [ Conclusions Reduning injection was safe and effective as adjuvant treatment for RMP complicated with VAP caused by AOPP.