醒脑静注射液联合阿托品治疗急性有机磷农药中毒伴呼吸衰竭的效果

Effect of Xingnaojing Injection Combined with Atropine in the Treatment of Acute Organophosphorus Pesticide Poisoning with Respiratory Failure

目的:探讨醒脑静注射液联合阿托品治疗急性有机磷农药中毒(AOPP)伴呼吸衰竭的效果。方法:选取定州市人民医院2015年2月-2018年2月收治的76例AOPP伴呼吸衰竭患者。按照随机数字表法将其随机分成观察组(n=38)与对照组(n=38)。所有患者一经确诊后均予以相同的常规处理,对照组在此基础上给予阿托品,观察组在对照组基础上加用醒脑静注射液。比较两组临床疗效、临床指标,治疗前后相关指标、炎症因子及胱抑素C(CysC)、CD4;/CD8;及不良反应。结果:治疗7 d后,观察组总有效率为89.5%(34/38),明显高于对照组的68.4%(26/38)(P<0.05)。观察组全血胆碱酯酶(ChE)活力恢复时间、阿托品化时间均早于对照组,阿托品用量少于对照组,有创通气时间短于对照组(P<0.05)。治疗后,观察组血清ChE水平、pH值、CD4;/CD8;均高于对照组,血清淀粉酶(AMS)、肌钙蛋白I(cTnI)和动脉血二氧化碳分压(PaCO;)、CysC、C反应蛋白(CRP)、细胞介素-18(IL-18)水平均低于对照组(P<0.05)。观察组不良反应明显低于对照组(P<0.05)。结论:AOPP伴呼吸衰竭应用醒脑静注射液联合阿托品治疗可迅速缓解患者中毒症状,改善血气状态,减轻炎性损伤,调节免疫平衡,保护脏器功能,疗效显著,安全可靠。

Objective:To explore the effect of Xingnaojing Injection combined with Atropine in the treatment of acute organophosphorus pesticide poisoning(AOPP)with respiratory failure.Method:A total of 76 patients with AOPP with respiratory failure treated in Dingzhou People’s Hospital from February 2015 to February 2018 were selected.According to the random number table method,they were randomly divided into observation group(n=38)and control group(n=38).Once diagnosed,all patients were given the same routine treatment.The control group was given Atropine on this basis,and the observation group was given Xingnaojing Injection on the basis of the control group.The clinical efficacy,clinical indexes,related indexes,inflammatory factors,Cystatin C(CysC),CD4;/CD8;before and after treatment and adverse reactions were compared between the two groups.Result:After 7 days of treatment,the total effective rate in the observation group was 89.5%(34/38),which was significantly higher than 68.4%(26/38)in the control group(P<0.05).The recovery time of whole blood cholinesterase(ChE)activity and Atropine time in the observation group were earlier than those in the control group,the dosage of Atropine was less than that in the control group,and the invasive ventilation time was shorter than that in the control group(P<0.05).After treatment,the levels of serum ChE,pH and CD4;/CD8;in the observation group were higher than those in the control group,and the levels of serum amylase(AMS),troponin I(cTnI),arterial blood carbon dioxide partial pressure(PaCO;),CysC,C-reactive protein(CRP)and interleukin-18(IL-18)in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group were significantly lower than that in the control group(P<0.05).Conclusion:The application of Xingnaojing Injection combined with Atropine in the treatment of AOPP with respiratory failure can quickly alleviate the poisoning symptoms of patients,improve blood gas status,reduce inflammatory injury,regulate immune balance and protect organ function.It has significant curative effect,safety and reliability.