中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2014年
16期
27-29
,共3页
呼吸机%阿托品%氯解磷定%有机磷农药%重度中毒%临床研究
呼吸機%阿託品%氯解燐定%有機燐農藥%重度中毒%臨床研究
호흡궤%아탁품%록해린정%유궤린농약%중도중독%림상연구
Respirator%Atropine%Pralidoxime chloride%Organophosphorus pesticide%Severe poisoning%Clinical research
目的：观察呼吸机联合不同剂量阿托品和氯解磷定治疗濒死重度有机磷农药中毒的临床效果。方法117例濒死重度有机磷农药中毒患者，根据是否用使用呼吸机分为呼吸机联合阿托品氯解磷定组(治疗组)，仅使用阿托品氯解磷定、未用呼吸机组(对照组)。治疗组根据入院后最大阿托品用量分为两亚组，适量组院最大用量≤100 mg/h；大剂量组院最大用量>100 mg/h。结果治疗组痊愈率高于对照组，差异有统计学意义(P<0.01)。两亚组比较，适量组死亡率和阿托品中毒率低于大剂量组，阿托品总用量少于大剂量组(P<0.01)。两亚组间机械通气时间、ICU住院时间、总住院时间差异无统计学意义(P>0.05)。结论抢救濒死重度有机磷农药中毒，应在阿托品联合复能剂的基础上应用机械通气，机械通气要及时，阿托品应该足量、个体化使用，尽量避免大剂量应用，用药过程中严密观察患者的反应。
目的：觀察呼吸機聯閤不同劑量阿託品和氯解燐定治療瀕死重度有機燐農藥中毒的臨床效果。方法117例瀕死重度有機燐農藥中毒患者，根據是否用使用呼吸機分為呼吸機聯閤阿託品氯解燐定組(治療組)，僅使用阿託品氯解燐定、未用呼吸機組(對照組)。治療組根據入院後最大阿託品用量分為兩亞組，適量組院最大用量≤100 mg/h；大劑量組院最大用量>100 mg/h。結果治療組痊愈率高于對照組，差異有統計學意義(P<0.01)。兩亞組比較，適量組死亡率和阿託品中毒率低于大劑量組，阿託品總用量少于大劑量組(P<0.01)。兩亞組間機械通氣時間、ICU住院時間、總住院時間差異無統計學意義(P>0.05)。結論搶救瀕死重度有機燐農藥中毒，應在阿託品聯閤複能劑的基礎上應用機械通氣，機械通氣要及時，阿託品應該足量、箇體化使用，儘量避免大劑量應用，用藥過程中嚴密觀察患者的反應。
목적：관찰호흡궤연합불동제량아탁품화록해린정치료빈사중도유궤린농약중독적림상효과。방법117례빈사중도유궤린농약중독환자，근거시부용사용호흡궤분위호흡궤연합아탁품록해린정조(치료조)，부사용아탁품록해린정、미용호흡궤조(대조조)。치료조근거입원후최대아탁품용량분위량아조，괄량조원최대용량≤100 mg/h；대제량조원최대용량>100 mg/h。결과치료조전유솔고우대조조，차이유통계학의의(P<0.01)。량아조비교，괄량조사망솔화아탁품중독솔저우대제량조，아탁품총용량소우대제량조(P<0.01)。량아조간궤계통기시간、ICU주원시간、총주원시간차이무통계학의의(P>0.05)。결론창구빈사중도유궤린농약중독，응재아탁품연합복능제적기출상응용궤계통기，궤계통기요급시，아탁품응해족량、개체화사용，진량피면대제량응용，용약과정중엄밀관찰환자적반응。
Objective To observe the clinical effect of respirator combined with atropine and pralidoxime chloride treating severe organophosphorus pesticide poisoning. Methods 117 cases of patients with severe organophosphorus pesticide poisoning were selected and divided into two groups,the treatment group (respirator combined with atropine and pralidoxime chloride group) and the control group (only using atropine and pralidoxime chloride without using res-pirator group).And according to the maximal dosage of atropine,the treatment group was divided into two subgroups.For the appropriate amount group,the maximal usage was less than or equal to 100 mg/h,and for the large dosage group,the maximal usage was greater than 100 mg/h. Results The recovery rate of the treatment group and control group had sig-nificant difference (P<0.01).For two subgroups,the death rate and poisoning rate of atropine in the appropriate amount group was lower than that of the large dosage group,and the total dosage of atropine was less than that of the large dosage group (P<0.01).There was no difference for the duration of ventilatory support,ICU length of stay and the total length of stay between two subgroups (P>0.05). Conclusion Rescuing the patients with severe organophosphorus pesti-cide poisoning should use mechanical ventilation based on atropine combined with pralidoxime chloride.Mechanical ventilation should be timely.And there is enough atropine,and it is used individually.And large-dosage application should be avoided.The reaction of patients should be observed in the medication process.
