氧化还原剂+输血+东莨菪碱抢救重度杀虫脒中毒200例

Effects of treatment with redox agent,blood transfusion and scopolamine on 200 patients with severe chlorphenamidine poisoning

目的 研究输血加用莨菪类药抢救重度杀虫脒 (氯苯甲脒 )中毒的治疗效果。方法 4 0 0例重度口服杀虫脒中毒患者随机分为 2组 ,Ⅰ组 (2 0 0例 )应用传统综合疗法 ,即洗胃、导泻 ,应用氧化还原剂 (亚甲蓝和维生素C)和对症治疗等。Ⅱ组 (2 0 0例 )在传统综合疗法基础上 ,加用输血和给予东莨菪碱。结果 Ⅱ组治愈率达 99.5 % ,明显优于Ⅰ组 (91.0 % ) ,差异有显著性 (P <0 .0 1) ;其平均病情好转时间 [(8.71± 1.4 9)h]明显快于Ⅰ组 [(10 .6 5± 1.72 )h],差异有显著性 (P <0 .0 1) ;其血高铁血红蛋白浓度 [入院后 3、7、12、2 4h分别为 (43.5 8± 2 .6 9)、(34.2 1± 2 .30 )、(2 0 .6 0±4 .0 3)、(13.5 0± 1.6 5 )g/L]恢复也明显快于Ⅰ组 [入院后 3、7、12、2 4h分别为 (5 4 .4 2± 12 .79)、(42 .17±2 2 .34)、(30 .6 6± 17.6 7)、(19.0 1± 0 .6 1)g/L],差异有显著性 (P <0 .0 1)。结论 输血和莨菪类药对重度杀虫脒中毒有独到疗效 ,可弥补氧化还原剂药理作用的不足 ,三者并用可加强解毒作用。

Objective To verify the effects of treatment with blood transfusion and scopolamine on severe chlorphenamidine poisoning(SCP). Methods 400 patients with severe oral chlorphenamidine poisoning were randomly divided into two groups.200 patients(Group Ⅰ) were treated with the traditional combined therapy including gastrolavage,purgation and taking redox agent (methylene blue and vitamin C) while the other 200 patients(Group Ⅱ) in addition to the above mentioned therapy,received blood transfusion and scopolamine injection. Results The cure rate of Group Ⅱ was 99.5% and significantly higher than that of Group Ⅰ(91.0%, P < 0.01) .The average time of improving in health in Group Ⅱ[(8.71±1.49)h] was obviously shorter than those in Group Ⅰ[(10.65±1.72)h, P <0.01 ].Blood methemoglobin concentrations in Group Ⅱ at 3,7,12,24 h after admission[(43.58±2.69),(34.21±2.30),(20.60±4.03),(13.50±1.65)g/L respectively] were obviously lower than those in Group Ⅰ[(54.42±12.79),(42.17±22.34),(30.66±17.67),(19.01±0.61)g/L respectively, P <0.01]. Conclusion Blood transfusion and scopolamine had distinctive therapeutic effect on SCP to make up the deficiency of redox agent.Combination of three therapies may potentiate the detoxication for chlorphenamidine.