解磷定治疗急性中重度有机磷中毒的系统评价  

PRALIDOXIME IN ACUTE ORGANOPHOSPHATE PESTICIDE POISONING:A SYSTEMATIC REVIEW

作　　者：李志强[1] 张印刚[1] 程爱斌[1] 邱方[1] 

机构地区：[1]华北煤碳医学院附属医院,唐山063000

出　　处：《现代预防医学》2011年第7期1229-1233,共5页Modern Preventive Medicine

摘　　要：[目的]评价解磷定对急性中重度有机磷中毒患者病死率、中间综合症发病率、需机械通气患者比例和机械通气时间的影响。[方法]计算机检索PubMed(1966～2009.10)、Cochrane Database(2009年第3期)、CBM(1978～2009.10)和CNKI(1979～2009),收集国内外关于解磷定对急性中重度有机磷中毒患者影响的随机对照试验,并进行系统评价。[结果]共6篇文献入选,1篇A级文献,其余为B级文献。分析显示长期高剂量应用解磷定可以降低病死率、中间综合征发病率、需机械通气患者比例和缩短机械通气时间(P﹤0.05),而短期高剂量应用对患者有害。[结论]长期高剂量应用解磷定可能对急性中重度有机磷患者有益。由于纳入文献的总体质量不高,尚需进行更多大样本、高质量随机对照试验来进一步证实解磷定的疗效。[Objective]To compare the effects of pralidoxime therapy on mortality rate,incidence of intermediate syndrome,need for mechanical ventilation and the duration of mechanical ventilation.[Methods]Randomized controlled trials（RCTs）were identified from PubMed（1966-2009.10）,Cochrane Database（Issue 3,2009）,CBM（1978-2009.10）and CNKI（1979-2009）.All RCTs of pralidoxime in acute moderate and severe organophosphorus pesticide poisoning were included,and a systematic review was performed.[Results]Six literatures were enrolled in the systematic review.The clinical benefit,including mortality,the incidence of intermediate syndrome,ventilatory requirements and duration of ventilation could be produced in long-term and high-dose application of pralidoxime subgroup,meanwhile,a detrimental effect was observed in short-term and low-dose application subgroup.[Conclusion]Based on the current available data,long-term and high-dose application of pralidoxime may be benefit in human organophosphate poisoning.The lack of high quality literatures,it needs large sample and high quality randomized controlled trials to confirm the role of pralidoxime in organophosphate poisoning.

关 键 词：有机磷化合物 中毒 解磷定化合物 系统评价 

分 类 号：R595[医药卫生—内科学]