盐酸戊乙奎醚治疗有机磷农药中毒的剂量及疗效研究

Dose and Efficacy of Penehyclidine Hydrochloride on the Treatment of Acute Organophosphorus Pesticide Poisonig

目的：探讨盐酸戊乙奎醚治疗有机磷农药中毒的剂量及疗效。方法：将76例有机磷农药中毒患者随机分为对照组及小剂量组,两组均予盐酸戊乙奎醚＋氯解磷定治疗。其中小剂量组按中毒程度轻、中、重中毒程度选用盐酸戊乙奎醚首次剂量分别为0.5-1 mg、1-2 mg、2-3 mg肌注,达戊乙奎醚化后再给予戊乙奎醚0.5-1 mg,每8-12小时1次维持治疗;对照组按中毒程度轻、中、重选用戊乙奎醚首次剂量分别为1-2 mg、2-4 mg、4-6 mg肌注,达戊乙奎醚化后再给予戊乙奎醚1-2 mg,每8-12小时1次维持治疗。两组均尽早给予氯解磷定同时治疗。观察两组患者用药情况、戊乙奎醚化和症状消失时间、胆碱酯酶活性变化情况及不良反应发生情况。结果：两组在治疗总有效率、戊乙奎醚化和症状消失时间以及胆碱酯酶活性变化情况方面比较,差异均无统计学意义（P〉0.05）。小剂量组首次给药量、总给药量较对照组少（P〈0.05）,口干、躁动及视力模糊不良反应发生率较对照组低（P〈0.05）。结论：小剂量盐酸戊乙奎醚治疗有机磷农药中毒疗效不变,不良反应减少,值得进一步扩大样本量研究。

Objective：To investigate the dose and efficacy of Penehyclidine hydrochloride in the treatment of organophosphorus pesticide poisoning.Method：76 patients with organophosphorus pesticide poisoning were randomly divided into control group and low dose group,both groups were treated with the Penehyclidine hydrochloride and pralidoxime chloride.According to light,middle and severe degree of poisoning,the low dose group was given the first dose of 0.5-1 mg,1-2 mg,2-3 mg penehyclidine hydrochloride intramuscular injection,0.5-1 mg in maintenance therapy per 8 to 12 hour after penehyclidine hydrochloride etherification.The control group was given the first dose of 1-2 mg,2-4 mg,4-6 mg Penehyclidine hydrochloride intramuscular injection,1-2 mg in maintenance therapy per 8 to 12 hour after penehyclidine hydrochloride etherification.The medication,time of Penehyclidine hydrochloride etherification and symptoms disappearance,changes of cholinesterase activity and the occurrence of adverse reactions of two groups were observed.Result：There were no significant difference of the total efficiency of treatment,time of Penehyclidine hydrochloride etherification and symptoms disappearance,changes of cholinesterase activity between two groups（P〉0.05）. Dosage for the first time,total dosage in low dose group were lower than those in the control group （P〈0.05）. The incidences of adverse reaction such as dry mouth,restlessness and blurred vision in low dose group were lower than those in control group（P〈0.05）.Conclusion：Low dose of Penehyclidine hydrochloride in the treatment of organophosphorus pesticide poisoning unchanged the efficacy,reduce adverse reactions,and it is worth to further study.