突击量氯磷定治疗急性有机磷农药中毒致呼吸肌麻痹76例观察

Comparison on effects between concentrated-dose and non-concentrated-dose pralidoxime chloride on respiratory muscle paralysis in acute organophosphorus pesticide poisoning

目的 比较突击量与非突击量氯磷定方案对急性有机磷农药中毒 (AOPP)致呼吸肌麻痹 (RMP)的治疗效果。方法 对 76例AOPP致RMP病人 ,根据救治时头 3d是否应用突击量氯磷定方案或近似突击量氯磷定方案 ,将病人分为两组。A组 30例 ,平均年龄 2 8 9岁。每天氯磷定用量≥10 0g ,平均 11 4g。B组病人 46例 ,平均年龄 30 7岁。每天氯磷定用量 <10 0g ,平均 6 3g。结果A组病人自主呼吸恢复时间平均 ( 2 0 9± 9 3)h ,治愈率 73 3% ,病死率 2 6 7% ;B组病人自主呼吸恢复时间平均 ( 47 1± 18 6 )h ,治愈率 2 1 7% ,病死率 78 3%。统计学处理 ,两组自主呼吸恢复时间及治愈率差异均有显著性 (前者t=7 5 6 ,P <0 0 0 1,后者 χ2 =19 83,P <0 0 0 5 )。结论 本研究表明突击量氯磷定救治方案对AOPP致RMP病人自主呼吸的恢复有较好疗效、能够明显提高临床治愈率。

Objective To compare the effects between concentrated-dose and non-concentrated-dose pralidoxime chloride on respiratory muscle paralysis(RMP) in acute organophosphorus pesticide poisoning(AOPP). Methods 76 cases of RMP due to AOPP were involved in a retrospective study. All the patients were poisoned through ingestion. According to the administered dose of pralidoxime chloride within the first three days after the onset,the patients were divided into two groups: Group A consisted 30 patients; they were given pralidoxime chloride 100～258 grams (with an average of 114 grams) everyday in the first three days after the onset. Group B included 46 patients; the dose of pralidoxime chloride used daily in the first three days ranged from 33 to 86 grams (average 63). Results The curative rate and the death rate in group A were 733% and 267% respectively ,while those in group B were 217% and 783% respectively. The curative rate in group A was significantly higher than that in group B (χ2 =1983,P<0005). Conclusion Concentrated-dose pralidoxime chloride was more effective than non-concentrated-dose for patients with RMP due to AOPP and this kind of administration could remarkably improve the prognosis in such patients.