不同剂量盐酸戊乙奎醚治疗急性有机磷农药中毒患者的临床效果分析

Clinical Effect of Different Doses of Penehyclidine Hydrochloride on Patients with Acute Organophosphorus Pesticide Poisoning

目的分析急性有机磷农药中毒患者在不同剂量盐酸戊乙奎醚治疗下的临床效果。方法随机选取2020年1月—2021年12月厦门市第三医院收治的60例急性有机磷农药中毒患者为研究对象,根据单双号分组原则,分为对照组30例和观察组30例。均予以盐酸戊乙奎醚治疗,对照组采取低剂量方案(即1~3 mg),观察组采取高剂量方案(即4~6 mg)。比较两组临床效果、治疗前后血清炎性因子变化、临床相关指标、不良事件发生率。结果观察组临床总疗效高于对照组,差异有统计学意义(P<0.05)。观察组治疗后白介素-6、C反应蛋白测定结果均低于对照组,差异有统计学意义(P<0.05)。观察组毒蕈碱样症状消失时间为(0.55±0.16)h、烟碱样症状消失时间为(1.13±0.32)h、中枢神经系统症状消失时间为(4.17±1.06)h、住院时间为(5.28±1.11)d均低于对照组,差异有统计学意义(t=14.899、12.394、10.030、6.751,P<0.05)。观察组治疗12 h后胆碱酯酶活性为(63.59±7.65)%,高于对照组的(55.52±6.92)%,差异有统计学意义(t=4.284,P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。观察组遗留症状发生率比对照组更低,差异有统计学意义(P<0.05)。结论应用高剂量盐酸戊乙奎醚治疗急性有机磷农药中毒患者的临床疗效显著,患者各临床指标改善效果良好,且未见更多不良反应,有助于减少遗留症状。

Objective To analyze the clinical effects of patients with acute organophosphorus pesticide poisoning treated with different doses of pentylenetetrazol hydrochloride.Methods 60 cases of acute organophosphorus pesticide poisoning patients admitted to the Third Hospital of Xiamen Municipality from January 2020 to December 2021 were randomly selected as study subjects,and were divided into 30 cases in the control group and 30 cases in the observation group according to the principle of single and double number grouping.All of them were treated with pentoxyverine hydrochloride,with the control group adopting a low-dose regimen(i.e.,1~3 mg)and the observation group adopting a high-dose regimen(i.e.,4~6 mg).The two groups were compared in terms of clinical effects,changes in serum inflammatory factors before and after treatment,clinically relevant indexes,and the incidence of adverse events.Results The total clinical efficacy of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The results of interleukin-6 and C-reactive protein measurements after treatment in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The disappearance time of muscarinic-like symptoms was(0.55±0.16)h,nicotinic-like symptoms was(1.13±0.32)h,central nervous system symptoms was(4.17±1.06)h,and hospitalization time was(5.28±1.11)d in the observation group were lower than those in the control group,and the differences were statistically significant(t=14.899,12.394,10.030,6.751,P<0.05).The cholinesterase activity of the observation group after 12 h of treatment was(63.59±7.65)%was higher than(55.52±6.92)%of the control group,and the difference was statistically significant(t=4.284,P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The incidence of residual symptoms was lower in the observation group than in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of high-dose penehyclidine hydrochloride in the treatment of patients with acute organophosphorus pesticide poisoning has significant clinical efficacy,and the clinical indicators of patients have a good improvement effect,and no more adverse reactions have been observed,which helps to reduce residual symptoms.