CAJ | 학술논문

目的：探讨血必净联合长托宁治疗急性有机磷农药中毒(A韵PP)的临床效果。方法将89例有机磷农药中毒患者按照治疗方式的不同分为对照组(38例)及观察组(51例)。对照组进行常规对症支持治疗、复能剂治疗、长托宁治疗及呼吸机支持治疗，观察组在对照组的基础上采用血必净治疗。比较两组患者入院时和治疗第3凿及治疗第5凿的心率(匀砸)、平均动脉血压(MA月P)、悦反应蛋白(悦砸P)、胆碱酯酶(悦澡耘)、同工酶(悦运-M月)水平以及血气相关指标(匀悦韵3-、P葬韵2、P葬悦韵2、责匀值)，并观察两组患者的死亡率及住院时间。结果治疗第3凿及治疗第5凿时，两组患者匀砸、MA月P、悦砸P、悦澡耘及悦运-M月水平均显著改善，且观察组匀砸、悦砸P和悦运-M月水平显著低于对照组，MA月P和悦澡耘显著高于对照组，差异均具有统计学意义(P<0.05)。治疗第3凿及治疗第5凿时，两组患者血气相关指标(匀悦韵3-、P葬韵2、P葬悦韵2、责匀值)均明显改善，且观察组匀悦韵3-、P葬韵2和P葬悦韵2的改善程度均优于对照组，差异具有统计学意义(P<0.05)。观察组死亡率与对照组相比差异不显著(P>0.05)，住院时间显著短于对照组(P<0.05)。结论血必净联合长托宁治疗急性有机磷农药中毒可有效减轻肺损伤，提升肺氧合状况，改善血气指标，缩短住院时间。
목적：탐토혈필정연합장탁저치료급성유궤린농약중독(A운PP)적림상효과。방법장89례유궤린농약중독환자안조치료방식적불동분위대조조(38례)급관찰조(51례)。대조조진행상규대증지지치료、복능제치료、장탁저치료급호흡궤지지치료，관찰조재대조조적기출상채용혈필정치료。비교량조환자입원시화치료제3착급치료제5착적심솔(균잡)、평균동맥혈압(MA월P)、열반응단백(열잡P)、담감지매(열조운)、동공매(열운-M월)수평이급혈기상관지표(균열운3-、P장운2、P장열운2、책균치)，병관찰량조환자적사망솔급주원시간。결과치료제3착급치료제5착시，량조환자균잡、MA월P、열잡P、열조운급열운-M월수평균현저개선，차관찰조균잡、열잡P화열운-M월수평현저저우대조조，MA월P화열조운현저고우대조조，차이균구유통계학의의(P<0.05)。치료제3착급치료제5착시，량조환자혈기상관지표(균열운3-、P장운2、P장열운2、책균치)균명현개선，차관찰조균열운3-、P장운2화P장열운2적개선정도균우우대조조，차이구유통계학의의(P<0.05)。관찰조사망솔여대조조상비차이불현저(P>0.05)，주원시간현저단우대조조(P<0.05)。결론혈필정연합장탁저치료급성유궤린농약중독가유효감경폐손상，제승폐양합상황，개선혈기지표，축단주원시간。
Objective To explore the clinical efficacy of xuebijing combined with penehyclidine hydrochloride in treatment of acute organophosphorus pesticide poisoning (AOPP). Methods 89 AOPP patients were divided into control group (38 cases) and observation group (51 cases) according to different treatment method. The control group was given conventional support treatment, rehabilitation, penehyclidine hydrochloride and ventilator support treatment, the observation group was given xuebijing injection on the baisis of control group. The levels of heart rate (HR), mean arterial blood pressure (MABP), C reactive protein (CRP), cholinesterase (ChE), CK-MB and blood gas related indexes (including HCO3-, PaO2, PaCO2, pH) on admission and 3 days and 5 days after treatment were compared, the mortality and hospitalization time were observed. Results After 3 days and 5 days of treatment , the levels of HR, MABP, CRP, ChE and CK-MB between two groups were improved, and the levels of HR, CRP, CK-MB in observation group were lower than those in control group, MABP and ChE were higher than those in control group, all the difference was statistical difference (P<0.05). After 3 days and 5 days of treatment, the blood gas related indexes of two groups were improved, and the improvement degree of HCO3-, PaO2 and PaCO2 in observation group were better than those in control group, with statistical difference (P<0.05). The mortality of two groups had no statistical difference (P >0.05), and the hospitalization time of observation group was significantly shorter than that of control group (P <0.05). Conclusions Xuebijing combined with penehyclidine hydrochloride can effectively reduce lung injury in treatment of AOPP, and can improve oxygenation status, improve blood indicators and shorten hospitalization time.