摘要
目的:探讨早期足量复能剂联合盐酸戊乙奎醚注射对急性有机磷农药中毒患者血清心肌酶及胆碱酯酶活性(CHE)的影响,为临床应用提供参考依据。方法:选取2021年11月—2023年6月本院收治的78例有机磷农药中毒患者作为研究对象,采用随机数字表法将其分为对照组和实验组,每组39例。对照组采用常规对症支持治疗、呼吸支持治疗+盐酸戊乙奎醚注射治疗,实验组在对照组基础上予以早期足量复能剂联合盐酸戊乙奎醚注射治疗。两组患者入院时、治疗第3 d、第5 d检测肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)水平及CHE活性,同时记录两组患者中毒症状消失时间、住院时间、死亡率。结果:与对照组比较,实验组中度、重度患者治疗后CK、CKMB、LDH峰值降低(P<0.05);与对照组比较,实验组治疗1 h、24 h中度、重度患者CHE活性升高(P<0.05);实验组中度、重度患者M样症状消失时间、N样症状消失时间、中枢神经症状消失时间均短于对照组中度、重度患者(P<0.05);实验组重度中毒患者IMS发生率、死亡率低于对照组,住院时间短于对照组(P<0.05)。结论:早期足量复能剂联合盐酸戊乙奎醚注射能降低有机磷农药中毒对患者心肌损伤的影响,快速改善中毒症状,恢复CHE活性,降低IMS发生率和死亡率。
Objective:To investigate the effect of early sufficient rehabilitation agent combined with penehyclidine hydrochloride injection on serum myocardial enzyme and cholinesterase activity(CHE)in patients with acute organophosphorus pesticide poisoning,and to provide reference for clinical application.Methods:A total of 78 patients with organophosphorus pesticide poisoning admitted to our hospital from November 2021 to June 2023 were selected as the research objects.They were divided into control group and experimental group by random number expression method,with 39 patients in each group.The control group was treated with conventional symptomatic support therapy,respiratory support therapy+penehyclidine hydrochloride injection.The experimental group was treated with early sufficient energy recovery agent on the basis of the control group.The levels of creatine kinase(CK),creatine kinase isoenzyme(CKMB),lactate dehydrogenase(LDH)and CHE activity were detected at admission,3 d and 5 d after treatment.The disappearance time of poisoning symptoms,hospitalization time and mortality were recorded in the two groups.Results:Compared with the control group,the peak values of CK,CKMB and LDH in the moderate and moderate patients in the experimental group decreased after treatment(P<0.05).Compared with the control group,the CHE activity of moderate and severe patients in the experimental group increased at 1 h and 24 h after treatment(P<0.05).The disappearance time of M-like symptoms,N-like symptoms and central nervous symptoms in moderate and severe patients in the experimental group were shorter than those in the control group(P<0.05).The incidence and mortality of IMS in patients with severe poisoning in the experimental group were lower than those in the control group,and the hospitalization time was shorter than that in the control group(P<0.05).Conclusion:Early sufficient rejuvenating agent combined with penehyclidine hydrochloride injection can reduce the effect of organophosphorus pesticide poisoning on myocardial injury in patients,quickly improve the symptoms of poisoning,restore CHE activity,and reduce the incidence and mortality of IMS.
作者
郭慧
苏浩
胡一航
段志荣
GUO Hui;SU Hao;HU Yihang;DUAN Zhirong(Emergency Department of the Seventh People's Hospital of Zhengzhou City,Zhengzhou 450000,Henan,China;Emergency and Critical Care Medicine Department of Zhengzhou Seventh People's Hospital,Zhengzhou 450000,Henan,China)
出处
《中国药物滥用防治杂志》
2025年第4期719-722,共4页
Chinese Journal of Drug Abuse Prevention and Treatment
基金
2024年度郑州市医疗卫生领域科技创新指导计划项目(编号:2024YLZD022)。
关键词
有机磷农药中毒
早期足量复能剂
盐酸戊乙奎醚注射液
心肌酶
肌酸激酶同工酶
胆碱酯酶活性
Organophosphorus pesticide poisoning
Early sufficient reenergizer
Penehyclidine hydrochloride injection
Myocardial enzymes
Creatine kinase isoenzyme
Cholinesteraseactivity
作者简介
郭慧(1996.08-),女,汉族,河南安阳人,本科,医师,主要研究方向:急诊;通信作者:段志荣(1973.01-),女,汉族,河南荣阳人,本科,副主任医师,主要研究方向:药物中毒。
