纳洛酮联合长托宁治疗中、重度有机磷农药中毒临床分析  

Clinical analysis of naloxone combined with penehyclidine hydrochioride in treating morderate to severe organophosphorus pesticide poisoning

作　　者：李海魂[1] 齐守罡[1] 张年萍[2] 

机构地区：[1]山西省大同市第三人民医院重症医学科,037008 [2]大同大学医学部内科教研室

出　　处：《中国实用医刊》2012年第10期70-71,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨纳洛酮联合长托宁在中、重度有机磷农药中毒的治疗中的作用及临床应用。方法将60例患者随机分为联合组、长托宁组和对照组，每组20例。联合组在对照组基础上加用纳洛酮，同时将阿托品改为长托宁；对照组采用传统方法，以阿托品联合氯磷定治疗为主；长托宁组以长托宁代替阿托品，同时运用氯解磷定等药物。纳洛酮首剂静脉注射1．2mg，随后静脉滴注1．6mg，连用5d。长托宁首剂4mg，肌肉注射，根据病情加量至阿托品化，并维持阿托品化。结果联合组总有效率（90．00％）高于长托宁组（75．00％）及对照组（50．00％），差异有统计学意义（P〈0．05）；在给药次数、住院天数方面，联合组明显少于对照组，差异有统计学意义（P〈0．01）。结论纳洛酮联合长托宁治疗中、重度有机磷农药中毒，相对于单用长托宁或不使用长托宁的常规治疗，能显著提高治愈率，降低病死率，无疑为一种有效的治疗方法。Objective To observe the therapeutic effect of penehyclidine hydrochloride com- bined with naloxone on moderate to severe organophosphorus pesticide poisoning. Methods Sixty cases of organophosphorus pesticide poisoning （taking orally）were randomly divided into penehyclidine hydrochloride-naloxone group, penehyclidine hydrochloride group and control group, 20 cases in each group. Patients in penehyclidine hydrochloride-naloxone group were treated with penehyclidine hydrochloride and naloxone, patients in penehyclidine hydrochloride group were only given penehy- clidine hydrochloride without naloxone, while patients in control group with pralidoxime chloride and atropine. Results The total effective rate in hydrochloride-naloxone group （90.00%） was higher than that in penehydidine hydrochloride group （75.00%） and control group （50.00%）, there were significant differences （ P 〈 0.05 ）. The differences in times and totol dosage of drug adminis- tration, the adverse effects of the atropinization and the recovery time between the control group and pene hyclidine hydrochloride-naloxone group were significant （P 〈 0.01 ）. The above-mentioned datas were significantly shorter in penehyclidine hydrochloride-naloxone group. Conclusions Pene- hyclidine hydrochloride combined with naloxone is more effective than traditional therapy of atropine for morderate to severe organophosphorus pesticides poisoning, which can increase the cure rate and lower the motality.

关 键 词：纳洛酮 长托宁 重度有机磷农药中毒 

分 类 号：R595.4[医药卫生—内科学]