生大黄与芒硝辅助治疗急性有机磷农药中毒

Raw Rhubarb and Sodium Sulfate in Treatment of Acute Toxicosis with Organophosphorus Pesticide

目的:探讨生大黄与芒硝辅助治疗急性有机磷农药中毒的临床效果,为急性有机磷农药中毒患者寻求更加有效的治疗方案。方法:将急性有机磷农药中毒患者161例,随机分为两组。对照组78例在常规治疗基础上给予甘露醇胃管注入;观察组83例在常规治疗基础上给予生大黄胃管注入和芒硝外敷。对两组患者首次排便时间、导泻期间排便次数、胆碱酯酶(cholinesterase,ChE)活性恢复时间、中间综合征(intemediatesyndrome,ISM)发生情况、住院时间、阿托品化时间、阿托品化用量以及阿托品总用量进行统计。结果:观察组患者首次排便时间、导泻期间排便次数、ChE活性恢复时间、ISM发生率、住院时间分别为(133.41±13.83) min、(2.71±0.28)次·d^(-1)、(9.36±0.83) d、6.02%和(10.17±1.04) d,对照组患者分别为(155.38±14.29) min、(2.28±0.21)次·d^(-1)、(10.71±1.36) d、29.49%和(11.73±1.93) d;观察组患者阿托品化时间、阿托品化用量以及阿托品总用量分别为(2.85±0.21) h、(51.07±3.85) mg和(221.17±20.36) mg,对照组分别为(3.61±0.32) h、(57.82±3.22) mg和(251.18±21.93) mg。两组比较,差异有统计学意义(P<0.05)。结论:生大黄水溶液鼻饲联合芒硝敷脐辅助治疗急性有机磷农药中毒,可以有效缩短患者的治疗时间,减少阿托品用量及治疗时间,减少ISM发生率,与甘露醇相比是一种更为有效且安全的导泻治疗方案。

Objective:To explore the clinical effect of raw Rhubarb and Sodium sulfate in treatment of acute toxicosis with organophosphorus pesticide,and to seek more effective treatment for acute toxicosis patients caused by organophosphorus pesticide.Methods:A total of 161 patients with acute organophosphorus pesticide poisoning were randomly divided into two groups.In the control group,78 patients were given mannitol gastric tube injection on the basis of conventional treatment;83 patients in the observation group were given rhubarb stomach tube injection and Glauber′s salt external application on the basis of conventional treatment.The first defecation time,the number of bowel movements during diarrhea,the recovery time of cholinesterase(ChE) activity,the occurrence of intermediate syndrome(ISM),hospitalization time,atropine time,atropine dosage and atropine Total usage was observed and measured.Results:The first defecation time,the number of bowel movements during the catharsis,the recovery time of ChE activity,the incidence of ISM,and the hospitalization time of the observation group were(133.41±13.83) min,(2.71±0.28) times·d-1,(9.36±0.83) d,6.02%,and(10.17±1.04) d,and that of the control group were(155.38±14.29) min,(2.28±0.21) times·d-1,(10.71±1.36) d,29.49%,and(11.73±1.93) d.The atropine time,atropine dosage and total atropine dosage in the observation group were(2.85±0.21) h,(51.07±3.85) mg and(221.17±20.36) mg,respectively,and that of the control group was(3.61±0.32) h,(57.82±3.22) mg and(251.18±21.93) mg.The difference between the two groups was statistically significant(P<0.05).Conclusion:Raw Rhubarb aqueous solution combined with mirabilite umbilical cord in treatment of acute toxicosis with organophosphorus pesticide can effectively shorten the treatment time,reduce the dosage of atropine and treatment time,reduce the incidence of ISM.It is more effective and safe treatment program than mannitol in catheterization.