CAJ | 학술논문

目的探讨救治有机磷农药中毒时选择阿托品与戊乙奎醚联合用药的最佳时机.方法将228例有机磷农药中毒患者随机分为三组,开始联合组在入院后即行阿托品、戊乙奎醚联合治疗,达阿托品化后,改用戊乙奎醚维持阿托品化状态,戊乙奎醚化联合组应用戊乙奎醚达阿托品化后再与阿托品联合,维持阿托品化状态.阿托品化联合组应用阿托品达阿托品化后再与戊乙奎醚联合,维持阿托品化状态;所有患者均给予护理干预,记录意识恢复时间、阿托品化时间、住院时间、戊乙奎醚用量,胆碱酯酶活力恢复50%、80%以上时间、药物耐受、药物依赖、迟发性神经病、中间综合征、中毒反跳、阿托品中毒及死亡情况.结果阿托品化联合组与开始联合组、戊乙奎醚化联合组比较意识恢复时间、阿托品化时间、胆碱酯酶活力恢复50%、80%以上时间、戊乙奎醚用量、住院时间、药物耐受、药物依赖、迟发性神经病、中间综合征、中毒反跳、阿托品中毒,差异有显著性(P<0.05 ,P<0.01).而开始联合组与戊乙奎醚化联合组比较意识恢复时间、阿托品化时间,差异有显著性(P<0.01),其他各项差异无显著性(P>0.05),三组死亡率比较无明显差异(P>0.05),阿托品化联合组效果明显优于开始联合组与戊乙奎醚化联合组.结论目前治疗重度有机磷农药中毒的较佳联合用药时机是快速达阿托品化后,再应用小剂量阿托品联合戊乙奎醚以维持阿托品化状态.
목적 탐토구치유궤린농약중독시선택아탁품여무을규미연합용약적최가시궤.방법장228례유궤린농약중독환자수궤분위삼조,개시연합조재입원후즉행아탁품、무을규미연합치료,체아탁품화후,개용무을규미유지아탁품화상태,무을규미화연합조응용무을규미체아탁품화후재여아탁품연합,유지아탁품화상태.아탁품화연합조응용아탁품체아탁품화후재여무을규미연합,유지아탁품화상태;소유환자균급여호리간예,기록의식회복시간、아탁품화시간、주원시간、무을규미용량,담감지매활력회복50%、80%이상시간、약물내수、약물의뢰、지발성신경병、중간종합정、중독반도、아탁품중독급사망정황.결과 아탁품화연합조여개시연합조、무을규미화연합조비교의식회복시간、아탁품화시간、담감지매활력회복50%、80%이상시간、무을규미용량、주원시간、약물내수、약물의뢰、지발성신경병、중간종합정、중독반도、아탁품중독,차이유현저성(P<0.05 ,P<0.01).이개시연합조여무을규미화연합조비교의식회복시간、아탁품화시간,차이유현저성(P<0.01),기타각항차이무현저성(P>0.05),삼조사망솔비교무명현차이(P>0.05),아탁품화연합조효과명현우우개시연합조여무을규미화연합조.결론 목전치료중도유궤린농약중독적교가연합용약시궤시쾌속체아탁품화후,재응용소제량아탁품연합무을규미이유지아탁품화상태.
Objective To explore the treatment of organophosphorus pesticide poisoning when choosing atropine and e YiKui ether combination in the best time. Methods 228 patients with organophosphorus pesticide poisoning were randomly divided into three groups, started joint group after admission line of atropine, e YiKui ether combination therapy, reached after the atropine, switch to e YiKui ether maintain atropine state; E YiKui etherification joint applied e YiKui ether of atropine group and atropine again after joint, maintain state of atropine. Atropine is changed after the joint group atropine application of atropine with e YiKui ether, maintain atropine state;Nursing, all patients were given the record con-sciousness recovery time, atropine, length of hospital stay, e YiKui ether dosage, cholinesterase activity recovery 50%, more than 80%of the time, drug resistance, drug dependence, late-onset mental derangement, bounce, atropine poisoning intermediate syndrome, poisoning and death. Results Atropine joint and start joint group, e YiKui etherification joint group consciousness recovery time, atropine, cholinesterase activity recovery 50%, more than 80% of the time, e YiKui ether dosage, length of hospital stay, drug resistance, drug dependence, late-onset neuropathy, intermediate syndrome, poi-soning bounce, atropine poisoning, significant differences (P<0.05, P<0.01). And start joint group compared with group e YiKui etherification joint consciousness recovery time, atropine, significant differences (P<0.01), there was no significant difference of various other significance (P>0.05), the three groups of mortality rate was no significant difference (P >0.05), the joint group is obviously better than the effect of atropine, began to joint with e YiKui etherification group. Con-clusion The treatment of severe organophosphorus pesticide poisoning the better combination of time is after the rapid of atropine, and application of combined e YiKui small doses of atropine ether to maintain state of atropine.