东莨菪碱治疗急性重度杀虫脒中毒的效果  

Effect of scopolamine on the acute severe chlorphenamidine poisoning patients

作　　者：何仁辉[1] 白宇鹏[2] 

机构地区：[1]湖北省荆州市荆州区中医院内科,434020 [2]华中科技大学同济医学院附属荆州医院内科

出　　处：《中华劳动卫生职业病杂志》2012年第4期298-300,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的研究东莨菪碱用于抢救急性重度杀虫脒中毒的治疗效果。方法72例急性重度杀虫脒中毒患者按入院先后次序，以1：1抽样原则分为Ⅰ、Ⅱ两组。Ⅰ组（36例）应用传统综合疗法，即洗胃、导泻、使用氧化还原剂（亚甲蓝和维生素c）和对症治疗等；Ⅱ组（36例）在传统综合疗法的基础上，加用东莨菪碱。所有患者在入院时、人院后3、7、12、24h均检测高铁血红蛋白水平；在人院后3、7、24、48h检测血清肌钙蛋白（CTn）Ⅰ和肌酸激酶同工酶（CK．MB）及肝、肾功能；每4h检查1次心电图（ECG），共3d。比较两组患者的疗效及检测指标变化。结果Ⅰ组治愈31例（86．11％），死亡5例（13．89％）；Ⅱ组36例全部治愈；Ⅱ组治愈率明显高于Ⅰ组，差异有统计学意义（P〈0．05）。Ⅱ组患者平均病情好转时间和平均住院天数均明显短于Ⅰ组，差异有统计学意义（P〈0．01）。Ⅱ组病例人院后7、24、48h血清中CtnI水平和3、7、24、48h血清中CK-MB水平均明显低于Ⅰ组，差异有统计学意义（P（0．05或P〈0．01）。人院后3、7、12、24h，Ⅱ组病例的高铁血红蛋白浓度均明显低于Ⅰ组，差异有统计学意义（P〈0．01）。人院后3、24、48h，Ⅱ组患者肝、肾功能异常率明显低于Ⅰ组，差异有统计学意义（P〈0．05）。Ⅱ组患者入院后第2、3天的ECG异常率（38．89％、11．11％）明显低于Ⅰ组（64．71％、38．71％），差异有统计学意义（P〈0．05）。结论东莨菪碱对治疗急性重度杀虫脒中毒有效，对心、肝、肾等重要器官有保护作用，可弥补氧化还原剂药理作用的不足。Objective To investigate effectiveness of scopolamine on the acute severe chlorphenamidine poisoning patients. Methods 72 cases of acute severe chlorphenamidine poisoning patients were divided intoⅠ and Ⅱ groups by the principle of a 1：1 sampling according to the order of admission. The Ⅰ group （36 cases） were treated with traditional muhimodality therapy, including gastrolavage, catharsis, using reductant-oxi- dant （methylthioninium chloride and vitamin C）, and symptomatic treatment. The Ⅱ group were treated with traditional muitimodality therapy and scopolamine at the same times. Blood methemoglobin were measured at 0, third, seventh, twelfth, twenty-fourth hour, serum troponin Ⅰ （CTnI） and creatine kinase isoenzyme （CK-MB） levels at third, seventh, twenty-fourth, forty-eighth hour, hepatic and renal functions at third, twenty-fourth, forty-eighth hour, and electrocardiogram （ECG） were evaluated every 4 hours in 3 days after hospitalization on all patients. The two groups of patients were compared the efficacy and change detection of targets. Results 31 patients （86.11% ） recovered and 5 patients （13.89%） died in Ⅰ group. All 36 cases recovered in II group. The recovery rate of Ⅱ group was distinctively higher than that in Ⅰ group （P〈0.05） and the difference was statisti- cally significant （P〈0.05）. The average recovery time and the length of hospital stay in Ⅱ group were sharply shorter than those in I group （P〈0.01） and the difference was statistically significant （P〈0.05）. Serum CTnI levels between seventh hour and forty-eighth hour, serum CK-MB levels between third hour and forty-eighth hour and methemoglobin concentration at third,seventh, twelfth, twenty-fourth hour were apparently lower in Ⅱ group, and the difference was statistically significant （P〈0.05）. The abnormal rates of hepatic and renal func- tions in II group were distinctively lower than those in Ⅰ group and the difference was statistically significant （P〈 0.

关 键 词：杀虫脒 中毒 东莨菪碱 治疗结果 

分 类 号：R595.4[医药卫生—内科学]