急性有机磷农药中毒规范化治疗研究  

Clinical trial on standard treatment of acute organophosphorus poisoning

作　　者：闫永建[1] 李秀菊[1] 宁国英[1] 赵学斌 潘永峰 闫晓勇 李治红[5] 张修伟 孙明霞[1] 李利 

机构地区：[1]山东省职业卫生与职业病防治研究院,济南250002 [2]济宁市人民医院 [3]郓城县人民医院 [4]单县东大医院 [5]济宁医学院附属医院 [6]鄄城县人民医院 [7]曹县人民医院

出　　处：《中华劳动卫生职业病杂志》2010年第5期321-324,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：山东省科技攻关计划（2005GGc03151）

摘　　要：目的探讨急性有机磷中毒（AOPP）规范化治疗方案。方法在前期研究的基础上，建立AOPP规范化治疗方案，选择某省农药中毒高发区6家医院开展临床试验研究。结果6家医院观察期内按照统一规范治疗方案共观察治疗AOPP患者422例，以口服中毒为主（97．16％），中、重度患者占87．44％。以规范治疗前2年的病例作为对照，采用规范治疗后，定点医院AOPP病死率从9．87％降至1．66％，差异有统计学意义（χ2=27．92，P〈0．01），明显低于同期该省报告综合救治水平（病死率为8．92％），差异亦有统计学意义（χ2=26．05，P〈0．01）。规范治疗组阿托品平均用量为（37．54±17．76）mg，较传统治疗组[（1280．70±69．22）mg]明显下降，差异有统计学意义（U=439．22，P〈0．01），静脉泵给药优于静脉注射给药。规范治疗组氯解磷定平均用量为（25．55±13．78）g，较传统治疗组[（12．11±3．56）羽明显增加，差异有统计学意义（U=19．48，P〈0．01）。未见药物中毒现象。结论AOPP治疗亟须规范，特别在广大农村地区。此次建立的规范治疗方案取得满意疗效，可明显降低AOPP病死率。Objective To explore the norms of treatment of acute organophosphorus pesticide poisoning （AOPP）, and observe the curative effect. Methods On basis of the pre-research, the norms of treatment of AOPP were summarized, and a multi-center clinical trial was performed in 6 hospitals selected from high incidence of AOPP in Shandong Province. Results 422 patients of AOPP in 6 hospitals in observation period were treated and observed by the norms of treatment. Among them, the proportion of oral poisoning was 97.16%, middle and severe degree were 87.44%. Compared with themselves 2 years ago before standard treat- ment, the curative effect of the norms of treatment for AOPP was much better than before. The mortality rate of AOPP declined from 9.87% to 1.66% （χ2=27.92, P〈0.01 ）, that was much better than the average therapeutic effect level of all our province in the same period （the mortality rate： 8.92% ） （χ2=26.05, P〈0.01 ）. The average amount of atropine [ （37.54±17.76 ） mg], dropped greatly [ （ 1280.70±69.22 ） mg] （U=439.22, P〈0.01 ）.The usage of atropine by continuous intravenous injection with venous pump was better than ordinary intravenous in- jection. The mean dosage of pralidoxime chloride increased twice than the previous （U=19.48,P〈0.O1）. There was no drug poisoning. Conclusion The standard treatment of AOPP is urgently needed in our country, espe- cially in rural area. By this trial, the satisfactory effect of the norms of treatment for AOPP summarized is observed and it reduces the fatality rate remarkably.

关 键 词：有机磷化合物 农药 临床方案 

分 类 号：R686[医药卫生—骨科学]