急性有机磷农药中毒治疗方法改良的疗效分析

The analysis of improved regimen in the treatment of acute organophosphorus pesticide poisoning

目的 :对三种方案治疗急性有机磷农药中毒进行临床分析 ,旨在探讨理想治疗方案。方法 :将我科近 12年收治的、中毒前无严重心、肺、肝、肾疾患的急性有机磷农药中毒34 4例作为分析对象 ,其中近 8年收治的 2 37例随机分成改良方案组 (甲组 ) 12 1例与解磷注射液组 (乙组 ) 116例 ,最初 4年收治的 10 7例为传统疗法组 (丙组 ) ,对三组的治愈率、住院时间、阿托品用量等进行比较。结果 :(1)治愈率 :在轻度中度时 ,甲组与乙组无显著差异性 ,乙组显著高于丙组。在中、重度中毒时 ,甲组显著或非常显著地高于乙组 ,乙组非常显著地高于丙组 (P <0 0 0 1)。(2 )住院时间 :甲组非常显著低于乙组 ,乙组非常显著低于丙组 (P <0 0 0 1)。(3)阿托品用量 :甲组非常显著低于丙组 (P <0 0 0 1)。(4)阿托品中毒 :甲组与乙组无显著差异性 ,乙组非常显著低于丙组 (P <0 0 1)。(5 )农药中毒反跳 :甲组非常显著低于乙组 (P <0 0 1) ,乙组显著低于丙组 (P <0 0 5 )。结论 :改良方案分别比传统疗法与解磷注射液疗法具有显著优越性 ,可视为治疗急性有机磷农药中毒理想方案。

Objective:To analyse the clinical effects of three treatment regimens of acute organophosphorus pesticide poisoning and to evaluate the best treatment regimen.Methods:344 subjects,who didn’t have severe diseases of the heart、lung、liver or kidney before poisoning in the past 12 years were chosen.237 cases were randomly divided into:improved regimen group 121 cases (group A) and Jielin Injection group 116 cases (group B) and 107 cases in the first 4 years belonged to traditional group (group C).The cure rate、the hospitalization days and the cumulative amount of atropine used were compared in each group.Results:(1)Although the cure rate in group A wasnt significantly higher than that of group B,group B was significantly higher than that of group C for mild poisoning.The cure rate in goup A was significantly or very significantly higher than that in group B for moderate poisoning and for severe poisoning(P<005 and P<001 respectively),so was group B vs goup C.(2)The hospitalization days in group A was very significantly lower than that of group B (P<0001),same for group Bvsgroup C.(3)The cumulative amount of atropine used in group A was very significantly lower than that in group C (P<0001).(4)Although the incidence of atropine poisoning in group A wasnt significantly higher than that in group B,group B was very significantly lower than that in group C (P<001).(5)The rebound of pesticide poisoning in group A was very significantly lower than that of group B (P<001),same for group B vs group C (P<005).Conclusion:The clinical effects of the improved regimen is better than that of the Jielin Injection and the traditional regimen and can be considered the best regimen in the treatment of acute organophosphorus pesticide poisoning.