急性重度有机磷农药中毒治疗中阿托品的临床应用(1)
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【摘要】目的 探讨在急性重度有机磷农药中毒治疗中阿托品的应用方法。方法 将38例AOPP患者随机分3组:A组阿托品采用间断静脉注射法;B组阿托品采用持续静脉推注法;C组阿托品采用首次剂量静脉注射后,再持续静脉推注法。比较各组患者临床疗效、治疗72h内的生命体征和血清胆碱脂酶活性变化。结果 与A组相比,B组和C组患者狂躁不安发生率、阿托品中毒发生率、阿托品总用量和反跳率均显著降低(P<0.01),平均住院天数、心率、瞳孔和体温的变化幅度明显减少(P<0.05),治疗48h后血清胆碱酯酶活性显著提高(P<0.01),治愈率明显上升(P<0.05)。C组在达阿托品化的时间方面较短于B组(P<0.05),其余各项无显著差异。结论 AOPP的救治中采用阿托品持续静脉推注, 疗效确切,并发症少,值得推广。
【关键词】阿托品 有机磷农药 中毒
中图分类号:R595.51 文献标识码:A 文章编号:1005-0515(2011)7-017-03
Therapeutic efficacy of atropine in treatment of acute severe organophosphorus pesticide poisoning
Huang Yang Yin Wen Hao Lu Qu Lijuan Zhang Lingqin
(Department of emergency, Xijing Hospital, Fourth Military Medical University, Xi′an 710032)
【Abstract】Objective To evaluate the efficacy of atropine in the treatment of the patients with acute severe organophosphorus pesticide poisoning. Methods 38 patients with acute severe organophosphorus pesticide poisoning were enrolled and divided into three groups. In A group, atropine was injected at regular intervals; In B group, atropine was used continually by Syringe pump; In C group, atropine was injected firstly, then used continually by Syringe pump. The clinical efficacy, vital signs and cholinesterase (CHE) activity were compared between groups during 72 hours-treatment by atropine. Results Compared with A group, the frequency of mania and atropine poisoning and the cumulative dosage of atropine and intoxicated rebound were significantly lower in B group and C group(P<0.01). The average hospitalization days in A group was higher than that of in B group and C group, the same with the levels of heart rates and temperature and pupil(P<0.05). The CHE activities determined after 48-72 hours treatment in B group and C group were significantly higher than A group's at the same time. Except the period of reaching atropinization, there were no obviously differences between B group and C group. Conclusion There was remarkably therapeutic efficacy using atropine continually by Syringe pump in treatment of acute severe organophosphorus pesticide ......
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