大剂量阿托品联合血浆置换、换血抢救重度急性有机磷农药中毒临床分析

Clinical Analysis of First Aid to Patients of Serious Acute Organophosphorus Pesticide Poisoning by Using Big Dosage of At- ropine in Combination with Plasma Exchange and Exchange Transfusion

目的:为了提高重度急性有机磷农药中毒的抢救成功率,探讨大剂量阿托品,联合血浆置换、换血治疗重度急性有机磷农药中毒的疗效。方法:重度急性有机磷农药中毒的患者,接受阿托品及胆碱酯酶复能剂(解磷啶)等综合治疗的同时,加用了血浆置换、换血治疗。结果:阿托品总用量达20710mg,血浆置换换血6h后,胆碱酯酶活力明显增高。89h后病人的意识恢复。结论:重度急性有机磷农药中毒治疗中阿托品的总剂量可因患者中毒程度而相差很大,在给予阿托品及胆碱酯酶复能剂等综合治疗的同时,加用血浆置换、换血治疗成功率会更高。

Objective:To observe the curative effect of big dosage of atropine, in combination with plasma exchange and exchange transfusion.for serious acute organophosphorus pesiticides poisoning in order to increase the successful rate of first aid. Methods: The patient of serious acute organophosphosphorus pesticides poisoning received multiple treatments such as atropine pyridine aldoxime methyliodide (PAM) and so on. At the same time the plasma and changing blood were exchanged.Results:20710 mg of atropine was used altogether.The cholinesterase(CHE) vitality was increased greatly 6 hours after exchanging plasma and blood .The consciousness of the patient recovered after 89 hours. Conclusion: The dosage of atropine used for treating the patient of serious acute organophosphorus pesticides poisoning is conspicuous difference because the poisoned degree is different. The successful rate of first aid will be improved if the patient is treated with atropin, PAM and so on in combination with plasma exchange and exchange transfusion.