摘要
目的探讨血液灌流联合盐酸戊乙奎醚注射液（长托宁）对急性重度有机磷农药中毒的临床疗效.方法选取重度有机磷农药中毒患者58例作为研究对象,采用随机数字表法分为观察组和对照组,每组29例.两组患者入院后均给予常规治疗和血流灌注治疗,观察组在此基础上加以长托宁治疗,观察两组治疗前后心肌酶、肝、肾功能指标、血气分析、胆碱酯酶活力以及其他治疗情况,并对结果进行比较分析.结果与对照组比较,治疗后观察组心肌酶、转氨酶、血淀粉酶以及肌酐水平明显降低,胆碱酯酶水平明显升高,氧分压（PaO2）明显升高,二氧化碳分压（PaCO2）明显降低,差异均有统计学意义（均P〈0.05）;观察组住院时间和胆碱酯酶活力恢复时间均较对照组明显缩短[（12.57±2.14）d比（16.35±2.73）d,（5.46±2.29）d比（7.61±3.47）d],且观察组治愈率明显高于对照组（100.00%比82.76%）,差异均有统计学意义（t=2.139、2.208,x2=5.472,均P〈0.05）.结论血流灌注能直接吸附有机磷农药,缩短胆碱酯酶的恢复时间,降低病死率,而联合长托宁不仅可以进一步提高血流灌注的临床疗效,还能起到保护器官的作用.
Objective To explore the clinical effect of blood perfusion combined with penehyclidine hydrochloride injection in the treatment of acute severe organophosphorus pesticide poisoning.Methods 58 patients with severe organophosphorus pesticide poisoning were selected as the research subjects.By using digital table method,they were randomly divided into observation group and control group,29 cases in each group.The two groups were given conventional treatment and blood perfusion treatment after admission,the observation group was treated with penehyclidine hydrochloride injection on this base.Before and after treatment,the myocardial enzymes,liver,kidney function index,blood gas analysis,cholinesterase activity,as well as other treatment of the two groups were observed,and the results were compared.Results Compared with the control group,after treatment,the myocardial enzyme,transaminase,serum amylase and creatinine levels in the observation group were significantly lower,cholinesterase level was significantly increased,the oxygen partial pressure increased,the partial pressure of carbon dioxide decreased obviously,the differences were statistically significant（all P〈0.05）.The hospitalization time and cholinesterase activity recovery time of the observation group were significantly shorter than those of the control group[（12.57±2.14）d vs.（16.35±2.73）d,（5.46±2.29）d vs.（7.61±3.47）d],and the cure rate of the observation group was significantly higher than that of the control group（100.00% vs.82.76%）,the differences were statistically significant（t=2.139,2.208,x2=5.472,all P〈0.05）.Conclusion Blood perfusion can directly adsorb organophosphorus pesticide,shorten the recovery time of cholinesterase and reduce the case fatality rate,and it combined with penehyclidine hydrochloride injection not only can improve the clinical curative effect of blood perfusion,but also can protect the organ.
出处
《中国基层医药》
CAS
2017年第16期2473-2476,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
中毒
农药
有机磷化合物
灌流
盐酸戊乙奎醚
Poisoning
Pesticides
Organophosphorus compounds
Perfusion
Penehyclidine hydrochloride
