两组用药清除有机磷农药中毒肠道毒物的临床观察

Effects of Chinese rhubarb combined with Smecta in treatment of organophosphorus pesticide poisoning

目的探讨大黄、思密达与硫酸镁、漂白土在治疗急性有机磷农药中毒的疗效。方法将76例口服有机磷中毒的重度患者随机均分2组。两组均给予彻底洗胃、适量应用长托宁及阿托品解毒，氯磷定复能剂等综合常规治疗。A组（治疗组）应用大黄导泻、思密达吸附；B组（对照组）应用硫酸镁导泻、漂白土吸附。观察首次排便时间，胃肠功能不全发生率及严重程度评分；观察胃肠功能恢复时间、阿托品化时间、意识恢复时间、胆碱酯酶活力恢复50％以上时间、阿托品和长托宁用量、药物耐受、中毒反跳、中间综合征、迟发性神经病、住院时间和死亡情况。结果治疗组各指标均优于对照组，均差异有统计学意义（均P〈0．01或P〈0．05）。结论思密达、大黄是目前彻底清除AOPP患者胃肠道残留毒物较好的导泻、吸附联合用药，减少了药物用量和并发症、缩短了住院时间。

Objective investigate the effects of Chinese rhubarb combined with Smecta in treatment of organopjophorus Pesticide poisoning. Methods Seventy-six patients with organophosphorus pesticide poisoning underwent conventional treatment including thorough gastric lavage, muscular injection of penehyckiine hydrochloride, intravenous injection of atropine through micropumping, and intravenous drip of pyraloxime methylchloride. The patients were randomly divided into 2 equal groups： Group A underdoing catharsis with 200 ml of Chinese Rhubarb powder and then suspension of Smecta through gastric tube 2h later as a cycle per 4 hours for 48 hours, and Group B undergoing irrigation of magnesium sulphate solution and suspension of Fuller＇s earth per 4 hours as a cycle for 48 hours. The effects were observed. Results The first defecation yime, recovery time of gastrointestinal tract, time of atropinization time, consciousness recovery time, recovery time of cholinesterase activity, and length of hospial stay of Group A were all significantly shorter than those of Group B （all P 〈0.05）; and the dosages of atropine and penehyckiine hydrochloride of Group A were both significantly lower than those of Group B （both P 〈0.01）. The rates of drug tolerance, intermediate syndrome, poisoning rebound, and delayed neuropathy were all significantly lower than those of Group B （all P 〈0.05, P 〈0.01）. Conclusion Chinese rhubarb combined with Smecta help cure organophosphorus pesticide poisoning.