文章摘要
纪海明,强 浩,胡守琴,安小峰,董飞超.不同剂量长托宁联合血液灌流在急性有机磷农药中毒中的应用效果观察[J].,2020,(13):2572-2575
不同剂量长托宁联合血液灌流在急性有机磷农药中毒中的应用效果观察
Observation on the Effects of Different Doses of Penehyclidine Combined with Hemoperfusion in Acute Organophosphorus Pesticide Poisoning
投稿时间:2020-02-23  修订日期:2020-03-17
DOI:10.13241/j.cnki.pmb.2020.13.037
中文关键词: 长托宁  血液灌流  急性有机磷农药中毒  剂量  疗效
英文关键词: Penehyclidine  Hemoperfusion  Acute organophosphorus pesticide poisoning  Dose  Efficacy
基金项目:安徽省重点研究与开发计划项目(1804h08020240)
作者单位E-mail
纪海明 皖北煤电集团总医院/蚌埠医学院第三附属医院急诊科 安徽 宿州 234099 13615577608@139.com 
强 浩 皖北煤电集团总医院/蚌埠医学院第三附属医院急诊科 安徽 宿州 234099  
胡守琴 皖北煤电集团总医院/蚌埠医学院第三附属医院急诊科 安徽 宿州 234099  
安小峰 皖北煤电集团总医院/蚌埠医学院第三附属医院急诊科 安徽 宿州 234099  
董飞超 皖北煤电集团总医院/蚌埠医学院第三附属医院急诊科 安徽 宿州 234099  
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中文摘要:
      摘要 目的:研究不同剂量长托宁联合血液灌流在急性有机磷农药中毒中的应用效果。方法:选取急性有机磷农药中毒患者66例,随机分为A、B两组,每组33例。A组患者给予大剂量长托宁及血液灌流治疗,B组患者给予小剂量长托宁及血液灌流治疗。对比两组临床治疗效果及住院期间不良反应发生情况,对比两组治疗前后实验室指标变化。结果:A组治疗后意识恢复时间、中毒症状消失时间、胆碱酯酶(CHE)恢复时间、住院时间分别为(1.64±0.42)d、(4.84±1.25)d、(4.75±1.21)d、(5.43±1.88)d,显著少于B组的(2.10±0.82)d、(5.22±1.84)d、(5.67±1.92)d、(7.24±2.45)d(P<0.05),且A组死亡率0.00%(0/33)显著低于B组的18.18%(6/33)(P<0.05)。A组治疗后二氧化碳分压(PaCO2)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平分别为(38.71±1.44)mmHg、(74.54±6.12)U/L、(24.45±3.57)U/L,显著低于B组治疗后的(42.43±2.45)mmHg、(82.78±8.57)U/L、(30.12±5.75)U/L(P<0.05),A组治疗后动脉血氧分压(PaO2)水平为(86.91±5.76)mmHg,显著高于B组治疗后的(83.76±4.87)mmHg(P<0.05)。两组不良反应总发生率(18.18% VS 11.11%)对比无显著差异(P>0.05)。结论:与小剂量用药相比,大剂量长托宁联合血液灌流治疗急性有机磷农药中毒疗效更好,且用药安全。
英文摘要:
      ABSTRACT Objective: To research the effects of different doses of penehyclidine combined with hemoperfusion in acute organophosphorus pesticide poisoning. Methods: 66 cases patients of acute organophosphorus pesticide poisoning were selected, they were randomly divided into groups A and B, 33 cases in each group. Patients in group A were treated with large dose of penehyclidine combined hemoperfusion, patients in group B were treated with small dose of penehyclidine and hemoperfusion. The clinical treatment effect and the occurrence of adverse reactions during hospitalization were compared between the two groups, the changes of laboratory indexes before and after treatment were compared between the two groups. Results: The recovery time of consciousness, the disappearance time of poisoning symptoms, the recovery time of cholinesterase (CHE) and the hospitalization time in group A was (1.64±0.42)d, (4.84±1.25)d, (4.75±1.21)d, (5.43±1.88)d respectively, significantly less than (2.10±0.82)d, (5.22±1.84)d, (5.67±1.92)d, (7.24±2.45)d in group B(P<0.05), the mortality rate of group A was 0.00% (0/33) significantly lower than that of group B 18.18%(6/33)(P<0.05). The level of partial pressure of carbon dioxide(PaCO2), creatine kinase(CK) and Creatine Kinase Isoenzyme(CK-MB) in group A after treatment was (38.71±1.44)mmHg, (74.54±6.12)U/L, (24.45±3.57)U/L respectively, significantly lower than (42.43±2.45)mmHg, (82.78±8.57)U/L, (30.12±5.75)U/L in group B after treatment(P<0.05), the arterial partial pressure of oxygen(PaO2) level in group A after treatment was(86.91±5.76)mmHg, significantly higher than(83.76±4.87)mmHg in group B after treatment(P<0.05). There was no significant difference in the total incidence of adverse reactions between two groups(18.18% VS 11.11%)(P>0.05). Conclusion: Compare with small dose, the treatment of acute organophosphorus pesticide poisoning with large dose of penehyclidine combined with hemoperfusion is more effective and safe.
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