血必净联合长托宁治疗急性有机磷农药中毒的临床研究

Clinical Research of Xuebijing Combined with Penehyclidine Hydrochloride in Treatment of Acute Organophosphorus Pesticide Poisoning

目的探讨血必净联合长托宁治疗急性有机磷农药中毒(AOPP)的临床效果。方法将89例有机磷农药中毒患者按照治疗方式的不同分为对照组(38例)及观察组(51例)。对照组进行常规对症支持治疗、复能剂治疗、长托宁治疗及呼吸机支持治疗,观察组在对照组的基础上采用血必净治疗。比较两组患者入院时和治疗第3 d及治疗第5 d的心率(HR)、平均动脉血压(MABP)、C反应蛋白(CRP)、胆碱酯酶(Ch E)、同工酶(CK-MB)水平以及血气相关指标(HCO3-、Pa O2、Pa CO2、p H值),并观察两组患者的死亡率及住院时间。结果治疗第3 d及治疗第5 d时,两组患者HR、MABP、CRP、Ch E及CK-MB水平均显著改善,且观察组HR、CRP和CK-MB水平显著低于对照组,MABP和Ch E显著高于对照组,差异均具有统计学意义(P<0.05)。治疗第3 d及治疗第5 d时,两组患者血气相关指标(HCO3-、Pa O2、Pa CO2、p H值)均明显改善,且观察组HCO3-、Pa O2和Pa CO2的改善程度均优于对照组,差异具有统计学意义(P<0.05)。观察组死亡率与对照组相比差异不显著(P>0.05),住院时间显著短于对照组(P<0.05)。结论血必净联合长托宁治疗急性有机磷农药中毒可有效减轻肺损伤,提升肺氧合状况,改善血气指标,缩短住院时间。

Objective To explore the clinical efficacy of xuebijing combined with penehyclidine hydrochloride in treatment of acute organophosphorus pesticide poisoning （AOPP）. Methods 89 AOPP patients were divided into control group （38 cases） and observation group （51 cases） according to different treatment method. The control group was given conventional support treatment, rehabilitation, penehyclidine hydrochloride and ventilator support treatment, the observation group was given xuebijing injection on the baisis of control group. The levels of heart rate （HR）, mean arterial blood pressure （MABP）, C reactive protein （CRP）, cholinesterase （ChE）, CK-MB and blood gas related indexes （including HCO3-, PaO2, PaCO2, pH） on admission and 3 days and 5 days after treatment were compared, the mortality and hospitalization time were observed. Results After 3 days and 5 days of treatment , the levels of HR, MABP, CRP, ChE and CK-MB between two groups were improved, and the levels of HR, CRP, CK-MB in observation group were lower than those in control group, MABP and ChE were higher than those in control group, all the difference was statistical difference （P〈0.05）. After 3 days and 5 days of treatment, the blood gas related indexes of two groups were improved, and the improvement degree of HCO3-, PaO2 and PaCO2 in observation group were better than those in control group, with statistical difference （P〈0.05）. The mortality of two groups had no statistical difference （P 〉0.05）, and the hospitalization time of observation group was significantly shorter than that of control group （P 〈0.05）. Conclusions Xuebijing combined with penehyclidine hydrochloride can effectively reduce lung injury in treatment of AOPP, and can improve oxygenation status, improve blood indicators and shorten hospitalization time.