急性有机磷农药中毒抢救治疗体会

Rescue treatment of acute organophosphorus pesticide poisoning

目的分析急性有机磷农药中毒抢救治疗方法。方法将本院2009年10月～2012年10月收治的50例有机磷农药中毒患者随机分为盐酸戊乙奎醚(长托宁)治疗组和阿托品治疗组各25例,并依据胆碱酯酶的活力将患者分为轻、中、重度,同时按照中毒程度应用不同剂量胆碱酯酶复活剂,并积极清除毒物,积极预防、处理各类并发症。结果所有中毒患者阿托品治疗组死亡9例,占36%,反跳4例,占16%;盐酸戊乙奎醚治疗组死亡患者5例,占20%,无反跳病例;两组差异有统计学意义(P<0.05)。结论盐酸戊乙奎醚在治疗急性有机磷农药中毒中疗效佳,中间综合征及中毒反跳发生率低,疗效持久。

Objective To analyze the rescue treatment of acute organophosphate poisoning. Methods Fifty cases of organophosphorus pesticide poisoning patients in our hospital from October 2009 to October 2012 were admitted and randomly divided into the hydrochloride penehyclidine treatment group and the atropine treatment group, patients were divided into mild, moderate and severe based on cholinesterase activity, and at the same time in accordance with the poisoning degree of application of different doses of cholinesterase resurrection agents, and active removal of toxic, ac- tive prevention, dealing with all kinds of complications. Reaults Among all poisoned patients, 9 patients （36%） died in the atropine treatment group, the rebound had 4 cases （16%）; 5 patients （20%） died in the hydrochloride penehycli- dine treatment group, no case of rebound; there was significant difference between two groups （P 〈 0.05）. Conclusion Hy- drochloride penehyclidine in the treatment of acute organophosphorus pesticide poisoning has clinical outcome, inter- mediate syndrome and the poisoning rebound incidence is low, has lasting effect.