碳酸氢钠联合血必净注射治疗急性重度敌敌畏中毒临床疗效  

Clinical effect of sodium bicarbonate combined with Xuebijing injection in the treatment of severe acute dichlorvos pesticide poisoning

作　　者：赵波[1] 肖磊[1] 孙宝泉[1] 于中锴[1] 高冬梅[1] 菅向东[2] 

机构地区：[1]聊城市人民医院急诊科,山东聊城252000 [2]山东大学齐鲁医院,山东济南250012

出　　处：《职业卫生与应急救援》2016年第1期6-8,29,共4页Occupational Health and Emergency Rescue

摘　　要：目的观察碳酸氢钠联合血必净注射液辅助治疗急性重度敌敌畏中毒的疗效。方法将符合研究条件的105例急性重度敌敌畏中毒患者,随机分为常规治疗组(n=52)和实验观察组(n=53)。常规治疗组给予清水彻底洗胃,实验观察组采用2.5%碳酸氢钠溶液洗胃。两组均给予导泻、吸氧、补液、利尿、解毒药物阿托品和氯磷定等治疗措施。实验观察组在综合治疗的基础上,加用5%碳酸氢钠注射液联合血必净注射液治疗,对比两组患者的临床治疗效果。结果实验观察组从第3天开始,胆碱酯酶活性高于常规治疗组,差异有统计学意义(P<0.05);达到阿托品化时间、阿托品总用量、氯磷定总用量、入住重症监护室时间及机械通气(>72 h)例数比例、血清hs CRP浓度、APACHEⅡ评分均低于常规治疗组,差异有统计学意义(P<0.05);两组患者的动脉血p H值、HCO_3^-浓度差异无统计学意义(P>0.05)。结论碳酸氢钠联合血必净注射液治疗急性重度敌敌畏中毒,可提高治疗效果,对胆碱酯酶活性的恢复呈现有益影响。Objective To observe the therapeutic efficacy of sodium bicarbonate combined with Xuebijing injection on severe acute dichlorvos pesticide poisoning. Methods A total of 105 eligible patients with severe acute dichlorvos pesticide poisoning were randomly divided into the conventional treatment group（n = 52）and the experimental observation group（n = 53）. The conventional treatment group were given thorough gastric lavage with water,and the experimental observation group were given gastric lavage with 2.5% sodium bicarbonate solution. Both groups were given such treatments as catharsis,administration of oxygen,fluid infusion,diuresis,and antidotes such as atropine and pralidoxime methylchloride. Furthermore,the patients in experimental observation group were treated with both 5% sodium bicarbonate injection and Xuebijing injection. Results The serum cholinesterase activity of patients in the experimental observation group was significantly higher than the conventional treatment group 3 days after treatment,and the difference was statistically significant（P〈0.05）.The time of atropinization,total atropine dosage,total pralidoxime methylchloride dosage,ICU stay time and the cases of mechanical ventilation（ 〉72 h）,serum hs CRP and APACHE Ⅱ score of the patients in the experimental observation group were significantly lower than in the conventional treatment group,and the differences were statistically significant（P〈0.05）. The arterial blood p H and HCO3-between the two groups had no significant difference（P〉0.05）. Conclusion Sodium bicarbonate combined with Xuebijing injection could improve the therapeutic effects,reduce complications and shorten EICU stay times in the treatment of severe acute dichlorvos pesticide poisoning,and contribute to the recovery of cholinesterase activity.

关 键 词：碳酸氢钠 血必净注射液 敌敌畏 中毒 胆碱酯酶 

分 类 号：R139.3[医药卫生—劳动卫生]