氯解磷定三种不同使用方法在急性有机磷农药中毒救治中的对比  

Comparison of three different administration methods of pralidoxime chloride in the treatment of acute organophosphorus pesticide poisoning

作　　者：顾慧珍[1] 刘素芝[1] 金文扬[1] 朱蔚[1] 朱海勇[1] 杨进[1] 秦杰[1] 

机构地区：[1]浙江省台州医院急救中心,浙江台州317000

出　　处：《中国急救医学》2008年第2期110-112,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的比较不同的氯解磷定用法在中、重度急性有机磷农药中毒(AOPP)救治中的疗效。方法将符合中、重度AOPP的患者随机分成负荷量后持续静脉注射氯解磷定组(A组)、反复注射氯解磷定组(B组)、静脉滴注氯解磷定2～3次/d组(C组),比较各组间阿托品和氯解磷定用量、并发症和不良反应发生情况、胆碱酯酶活性(CHE)恢复时间、平均住院时间等指标。结果A、B两组救治过程中氯解磷定总用量均大于C组(P<0.01),阿托品针总用量均小于C组(P<0·01,P<0·05),中间综合征发生率、死亡率及平均住院时间均小于C组(P<0.01);入院治疗12h时A、B、C各组CHE比较差异无统计学意义(P>0.05);入院治疗24、48、72h时A组和B组CHE测量值均优于C组(P<0.05);而A组与B组以上各项指标比较差异均无统计学意义(P>0.05)。A组药物用量和其他不良反应明显少于B组与C组(P<0.01)。结论负荷量后持续静脉注射氯解磷定和反复注射氯解磷定两种方法在救治AOPP时优于分次静滴氯解磷定法,而前两种方法之间比较差异无统计学意义。Objective To compare different administration methods of pralidoxime chloride in the treatment of severely acute organophosphorus pesticide poisoning （ AOPP） and to observe the curative effect. Methods The patients with severely AOPP were randomly divided into continuous intravenous infusion of pralidoxime chloride group （ group A ） , repeated injection of pralidoxime chloride group （ group B）, the infusion of pralidoxime chloride 2 - 3 times / day group （ group C ）. To compare atropine and pralidoxime chloride dosage in the different groups, adverse reactions and complications, CHE recovery time, the average length of stay in hospital etc. Results Compared with group C, the total volume of pralidoxime chloride was more（ P 〈 0.01）, but atropine dosage was less, incidence of intermediate syndrome, mortality, and the average time in hospital was lower in group A and B （ P 〈0.01 ）. The differences of CHE were not significant in A, B, and C groups after 12 - hour treatment （ P 〉 0.05 ）. At 24, 48, 72 h, CHE was better in group A and group B than in group C, the difference was significant （ P 〈 0.05 ）. In group A and group B, the above indicators were compared, the difference was not significant （ P 〉0.05）. Drugs and other adverse reactions were significantly less in group A than in group B and group C, the difference was significant （ P 〈 0. 01 ）. Conclusions Continuous intravenous injection and repeated injection of pralidoxime chloride in the treatment of AOPP is superior to fractional infusion of pralidoxime chloride, and the first two methods were not significantly different.

关 键 词：急性有机磷农药中毒 氯解磷定 

分 类 号：R595.4[医药卫生—内科学]