中重度急性有机磷农药中毒的氯解磷定用量系统评价  

The dosage of pralidoxime in acute organophosphorus pesticide poisoning:A systematic review

作　　者：王磊[1] 唐泽海[1] 陈奎[1] 韩继媛[1] 樊红[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院急诊科,武汉430022

出　　处：《临床急诊杂志》2014年第6期334-337,共4页Journal of Clinical Emergency

摘　　要：目的:系统评价中重度急性有机磷农药中毒的氯解磷定剂量,比较氯解磷定的不同剂量对抢救中重度急性有机磷中毒的疗效和安全性,寻求氯解磷定在中重度急性有机磷农药中毒的最佳治疗剂量。方法:从常用中、外文电子数据库检索氯解磷定治疗中重度有机磷农药中毒用量相关文献,将相关数据进行整理后通过stata11.0软件进行荟萃分析。结果:共10项临床试验符合纳入标准。主要结局指标:治愈率:获得5项研究结果,I2=0.00%,P=0.782>0.05,OR 95%,CI为6.88(3.97,11.93)。死亡率:共10项资料报道了患者的临床死亡例数/率,结果总I2=13.9%,P=0.315>0.05,OR 95%,CI为0.18(0.11,0.28)。阿托品总量:获取6组数据,总I2=99.7%,P=0.000<0.05,SMD 95%,CI为-4.45(-9.50,-0.60)。平均住院时间:最终可获取5组资料,I2=92.3%,P=0.000<0.05,SMD 95%,CI为-0.89(-1.56,-0.22)。结论:大剂量应用氯解磷定可以降低中重度急性有机磷中毒患者的死亡率,减少阿托品用量及患者平均住院时间,但由于所纳入文献大部分为病例对照研究,尚需进行更多大样本、高质量随机对照试验来进一步证实氯解磷定的疗效。Objective：To systematically evaluate the dosage of pralidoxime in acute organophosphorus pesticide poisoning. To quantify the effectiveness and safety of the administration of different dosage of oximes in acute organophosphorus pesticide poisoned patients. The better dosage of pralidoxime for the treatment in acute organo phosphosphorus was seeked. Method..We searched both English and Chinese databases. All articles of pralidoxime in acute organophosphorus pesticide poisoning were included,and a systematic review was performed through the tatistical Software Stata 11.0. Result： Ten literatures were enrolled in the systematic review. The cure rate in five studies showed the summary OR was 6.88（95 %CI 3.97 to 11.93） ,I^2=0.00% ,P=0. 782〉0.05. Mortality in ten studies showed the summary OR was 0.18,95%CI（0.11 to 0.28）,I^2= 13.9%,P=0. 315〉0.05. The dosages of atropine in six studies showed the summary SMD was -4.45,95%CI（-9.50,-0.60） ,I^2=99.7% ,P=0. 000〈 0.05. Hospitalisation days in five studies showed the summary SMD was-0.89,95% CI（- 1.56,-0.22）, I^2 = 92. 3 %, P= 0. 000〈0.05. Conclusion： Based on the current available data, the megadose of pralidoxime may be benefit in human organophosphate poisoning that significantly improve cure rate reduce the mortality,the dosages of atropine and hospitalization days. 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：氯解磷定 剂量 急性有机磷农药中毒 死亡率 系统评价 

分 类 号：R595[医药卫生—内科学]