规范阿托品应用治疗有机磷中毒临床探讨  

A clinical study of the standard application of atropine for treatment of organophosphate poisoning

作　　者：李振富[1] 窦忠东[1] 郝德英[1] 马君秀[1] 甄国栋[1] 李振翮[1] 

机构地区：[1]山东省临沂市沂水中心医院急诊科,276400

出　　处：《中国实用医刊》2011年第14期8-11,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨急性有机磷农药中毒特效解毒药物的最佳应用时机及剂量，以提高治愈率。方法采用随机分组的方法，把我院救治的1192例急性有机磷农药中毒患者分为两组，实验组560例，阿托品的应用方法是快速消除中毒症状后停药观察，待再出现轻微中毒症状时再次应用阿托品；氯磷定仅应用1～2d。对照组632例采用传统治疗方法，达到传统阿托品化标准后维持一段时间，逐渐减量，直至停用阿托品。收集两组氯磷定和阿托品应用时间、应用总量、住院天数和不良反应等资料，并对两组资料进行统计学分析。结果实验组几乎无尿潴留、烦躁不安和呼吸衰竭等不良反应的发生，解毒药物的应用时间及总量亦明显少于对照组，大部分患者24h即可不再应用解毒药物且经观察无反跳病例发生。结论新的应用方法在急性有机磷农药中毒治疗中能明显提高治愈率、缩短住院时间、减少过量应用阿托品及氯磷定造成的不良反应。Objective To study the best timing and dosage of detoxification application for acute organophosphorus pesticide poisoning for the improvement of cure rate. Methods One thousand one hundred and ninety - two cases of acute organophosphorus pesticide poisoning, treated in our hospital, were included and randomly divided into two groups. For the 560 cases in the experimental group, application of atropine was withdrawn when poisoning symptoms were observed to disappear rapidly. When mild symptoms appeared, atropine was applied again. Pyraloxime methylehloride was used for only 1 - 2 days. Six hundred and thirty - two cases in the control group were treated with traditional methods until atropinization and then lasted for several days, and gradually reduced until withdrawal. Information collected included application time, application dose, length of stay and adverse reaction of pyraloxime methylchloride and atropine. Two sets of data were analyzed statistically. Results Uretention, irritability, respiratory failure and other adverse reactions did not occur in the experimental group. Application time and total dose of the detoxification drug was also significantly less than the control group. Most patients could no longer be applied with detoxification drug after 24 hours and no rebound occurred after observation. Conclusions The application of new methods in the acute orgartrophosphorus pesticide poisoning treatment can significantly improve the cure rate, shorten hospital stay and reduce adverse reactions that are caused by application of atropine and pyraloxime methylchloride excessively.

关 键 词：急性有机磷农药中毒 阿托品化 解毒药物 氯磷定 阿托品 

分 类 号：R595.4[医药卫生—内科学]