长托宁、阿托品联合血液灌流治疗急性有机磷农药中毒伴呼吸衰竭的临床疗效

Clinical Effect of Penehyclidine Hydrochloride, Atropine Plus Hemoperfusion On Patients with Acute Organophosphorus Pesticide Poisoning Combined with Respiratory Failure

目的:探讨长托宁、阿托品联合血液灌流治疗急性有机磷中毒伴呼吸衰竭的临床疗效。方法:选取2009年1月至2016年8月在我院治疗的重症有机磷农药中毒伴呼吸衰竭患者68例,随机分为2组,A组35例,B组33例,A组患者接受长托宁联合阿托品常规治疗,B组患者接受长托宁、阿托品联合血液灌流治疗。比较两组患者治疗期间血清乙酰胆碱酶、肌酸激酶的含量以及治疗情况、临床疗效,同时记录治疗期间不良反应的发生情况。结果:治疗期间,B组患者血清Ach E的含量显著高于A组患者(P<0.05),血清CK含量显著低于A组患者(P<0.05);B组患者的清醒时间、到达阿托品化时间、中毒症状消失时间以及住院时间显著低于A组患者(P<0.05);B组患者的病死率以及不良反应的发生率显著低于A组(P<0.05);B组患者治疗的总有效率显著高于A组(P<0.05)。结论:长托宁、阿托品联合血液灌流可以显著缓解急性有机磷中毒伴呼吸衰竭患者体内胆碱能紊乱的状态,提高临床疗效,并且有效降低治疗期间不良反应的发生率。

Objective：To explore the clinical effect ofpenehyclidine hydrochloride,atropine plus hemoperfusion （HP） on patients with acute organophosphorus pesticide poisoning（AOPP） combined with respiratory failure.Methods：68 patients with AOPP enrolled in our hospital from January 2009 to August 2016 were selected and randomly divided into two groups.Group A （n=35） accepted penehyclidine hydrochloride and atropine,and Group B （n=33） adopted hemoperfusion based on Group A.The acetylcholine enzyme and creatine kinase content in serum,curative effect and incidence of adverse reactions were compared during treatment between two groups.Results：In the period of treatment,the level of acetylcholine enzyme in Group B was significantly higher than that in the Group A （P〈0.05）,and the content ofcreatine kinase in Group B was significantly lower than that in Group A （P〈0.05）.The time of waking,atropinization,poisoning symptoms vanished and hospital stay in Group B were significantly shorter than those in Group A （P〈0.05）;The morbidity and incidence of adverse reactions in Group B were obviously decreased compared with Group A （P〈0.05）.Conclusions：Penehyclidine hydrochloride,atropine plus HP not only relieved the cholinergic disorders significantly,improved the clinical efficacy,but also decreased the incidence of adverse reactions in the treatment of AOPP combined with respiratory failure.