呼吸机联合不同剂量阿托品与氯解磷定治疗重度有机磷农药中毒疗效的比较研究

Curative effect of breathing machine combined with different dose of atropine and pralidoxime chloride in the treatment of severe organophosphorus pesticide poisoning

目的比较重度有机磷农药中毒治疗中采用呼吸机联合不同剂量阿托品与氯解磷定的疗效。方法将收治的76例重度有机磷农药中毒患者,随机分为两组,其中观察组予以适量阿托品联合氯解磷定治疗,对照组予以最大剂量阿托品联合氯解磷定治疗,治疗后观察两组患者的治愈情况、生命体征以及治疗相关指标。结果与对照组比较,观察组的胆碱酯酶活力好转所需时间、血糖浓度水平稳定所需时间、APACHEⅡ评分、死亡率,以及生命体征如意识、体温、脉搏,阿托品用量、并发症发生率均降低明显,差异具有统计学意义(P<0.05,P<0.01),治愈率升高明显,差异具有统计学意义(P<0.05)。结论在重度有机磷农药中毒患者中应用阿托品联合氯解磷定的基础上应用呼吸机机械通气,阿托品应适度、足量应用,可有效改善患者的生命体征及实验室指标,提高治愈率,降低死亡率,应避免大剂量应用。

Objective To compare the curative effect of breathing machine combined with different dose of atropine and pralidoxime chloride in the treatment of severe organophosphorus pesticide poisoning. Methods 76 cases of severe organophosphorus pesticide poisoning patients were randomly divided into 2 groups. The observation group was given quantum sufficit atropine and pralidoxime chloride, and the control group was given the biggest dose of atropine and pralidoxime chloride. Their cure status, vital sign and treatment related indexes were observed and compared. Results Compared with the control group, the observation group had shorter cholinesterase activity im- proved time and blood sugar concentration level stabilized time, lower APACHE 11 score, mortality, and incidence of vital signs such as, consciousness, temperature and pulse, and lower atropine dose （P 〈 0. 05, P 〈 0. 01 ）. The cur- ative rate was obviously higher in the observation group than in the control group （P 〈 0. 05 ）. Conclusion Breathing machine combined with quantum stffficit atropine and pralidoxime chloride can effectively improve the curative rate and reduce the mortality in the treatment of severe organophosphorus pesticide poisoning patients.