CAJ | 학술논문

目的探讨美托洛尔治疗有机磷中毒患者快心率的可行性及安全性.方法 79例急性重度有机磷农药中毒患者合并心率明显增快者为研究对象,收集阿托品用量不足和阿托品化患者应用美托洛尔前及应用后24h的心率、阿托品应用速率、血压、心脏指数、氧合指数、瞳孔大小及皮肤干燥、躁动、腹泻发生率等参数,予以分析比较.结果两组患者应用美托洛尔前及用后24 h心率均见明显下降[(148±20)次/min vs(115±13)次/min]、[ 145±21)次/min vs( 106±16)次/min],P＜0.05,但平均动脉压、心脏指数、氧合指数比较无显著变化(P＞0.05)；阿托品用量不足组阿托品应用速率增加[(3.1±1.9)mg/h vs (9.6±4.5) mg/h,P＜0.05],胆碱能症状改善；阿托品化组除心率之外的阿托品化表现及阿托品应用速率无显著变化[(10.1±5.8)mg/h vs (9.9±4.5) mg/h,P＞0.05)].结论美托洛尔可有效拮抗有机磷中毒患者应用阿托品后的心率增快,且对呼吸循环功能无显著影响,不干扰阿托品化指标的综合判断.
목적 탐토미탁락이치료유궤린중독환자쾌심솔적가행성급안전성.방법 79례급성중도유궤린농약중독환자합병심솔명현증쾌자위연구대상,수집아탁품용량불족화아탁품화환자응용미탁락이전급응용후24h적심솔、아탁품응용속솔、혈압、심장지수、양합지수、동공대소급피부간조、조동、복사발생솔등삼수,여이분석비교.결과 량조환자응용미탁락이전급용후24 h심솔균견명현하강[(148±20)차/min vs(115±13)차/min]、[ 145±21)차/min vs( 106±16)차/min],P＜0.05,단평균동맥압、심장지수、양합지수비교무현저변화(P＞0.05)；아탁품용량불족조아탁품응용속솔증가[(3.1±1.9)mg/h vs (9.6±4.5) mg/h,P＜0.05],담감능증상개선；아탁품화조제심솔지외적아탁품화표현급아탁품응용속솔무현저변화[(10.1±5.8)mg/h vs (9.9±4.5) mg/h,P＞0.05)].결론 미탁락이가유효길항유궤린중독환자응용아탁품후적심솔증쾌,차대호흡순배공능무현저영향,불간우아탁품화지표적종합판단.
Objective To investigate the effectiveness and safety of Metoprolol on tachycardia in acute organophosphorus pesticide poisoning(AOPP) patients.Methods Through general analyze of 79 cases of severe AOPP with tachycardia were divided into atropine insufficiency group and atropinization group,some parameters were collected and compared between pro - Metoprolol administered and 24 h post- Metoprolol administered which includes the HR,atropine infusion rate,mean artery pressure (MBP),cardiac index(CI),oxygenation index(OI),size of pupil,the rate of skin dryness/diarrhea /dysphoria.Results The HR was significantly decreased in two groups( 148 ±20 vs 115 ± 13,145 ±21 vs 106 ± 16 beats per minute,P ＜0.05),there were no significant differences in MAP/CI/OI.In atropine insufficiency group,atropine infusion rate was increased [ (3.1 ± 1.9) mg/h vs (9.6 ± 4.5 ) mg/h,P ＜ 0.05 ],cholinergic symptoms were improved; In atropinization group,there was no significant difference in atropine infusion rate[ (10.1 ± 5.8) mg/h vs (9.9 ± 4.5) mg/h,P ＞ 0.05] and cholinergic symptoms.Conclusions Metoprolol can reduce the HR in severe AOPP patients with tachycardia,but has no influence on the patients' cardiopulmonary function,no interference on the general judgement of atropinization.