盐酸戊乙奎醚阶梯方案对重度有机磷中毒及中间综合征的临床研究

【摘要】  目的：探讨盐酸戊乙奎醚(长托宁)阶梯方案对急性重度有机磷农药中毒(AOPP)及中间综合征(IMS)的临床效果。方法：82例重度AOPP随机分为治疗组和对照组,治疗组(n=43)采用6 h长托宁阶梯方案：负荷量按照曾繁忠推荐用法，长托宁4～6 mg肌注，首剂后1 h长托宁2～3 mg 1次/h，连用2次后，2～3 mg 2次/h连用2次，2mg 1次/4～6 h为维持量;对照组(n=41)按以上推荐负荷量后0.5～1h常规长托宁2 mg 1次/4～6 h肌内注射为维持量。氯磷定治疗方法相同。根据长托宁化及其意识、体温等调整维持量。结果：与对照组相比，治疗组达到长托宁化的时间(t=8.551，P<0.01)、IMS发生率(χ2=7.201，P<0.01)明显低于对照组，机械通气时间(t=11.491，P<0.05)、死亡率(χ2=4.808，P<0.05)明显低于对照组;总长托宁用量比较，无统计学意义(t=0.482，P﹥0.05)。无长托宁严重反应及中毒死亡的患者。结论：长托宁阶梯方案能早期4h达到长托宁化，与常规用法相比，能更明显降低重度AOPP的死亡率及IMS的发生率。

【关键词】  盐酸戊乙奎醚;急性有机磷农药中毒 ;中间综合征;阶梯方案

Clinical study on Penehyclidine hydrochloride ladder program for severe organophosphate poisoning and intermediate syndrome XU Bang-fu，HU Jian-gong，WANG Chun-guang，et al (The Hospital of Jieshou City，Jieshou 236500，China)

　　Abstract：ObjectiveTo explore the clinical effects of Penehyclidine (Long-Thorning) ladder program on acute severe organophosphorus pesticide poisoning (AOPP) and intermediate syndrome (IMS).MethodTotal 82 patients with severe AOPP were randomly divided into the treatment group and the control group.The treatment group (n=43) received Long-Thorning ladder program，the first dose according to Zeng Fanzhong recommended usage，Long-Thorning 4-6mg intramuscular injection，after the first dose of 1h，Long-Thornin 2-3mg q1h ×2，2-3mg q2h×2，2mg q4-6h intramuscularly to maintain the amount.The control group(n=41) according to the above recommendation，after loading 0.5-1h，Long-Thorning 2mg q4-6h order to maintain the amount.PAM-treated the same way.ResultsTime spent to achieve Long-Thorning and IMS incidence rate of the treatment group were significantly lower than the control(t=8.551，χ2=7.201，P<0.01)，duration of mechanical ventilation and mortality were lower than the control(t=11.491，χ2=4.808，P<0.05).ConclusionLong-Thorning ladder program can reduce IMS incidence rate and mortality of the patients with severe AOPP.

　　Key Words:Penehyclidine

[1] [2] [3] [4] 下一页