HI-6和阿托品并呼吸机治疗氧化乐果中毒呼吸肌麻痹的实验研究  

Study on the therapeutic effect of combined use of HI-6 and atropine with artificial ventilation on respiratory muscle paralysis caused by omethoate poisoning in rats

作　　者：邱泽武[1] 史寅奎[1] 黄韶清[1] 赵德禄[2] 

机构地区：[1]军事医学科学院附属医院全军中毒救治中心急诊科,北京100039 [2]军事医学科学院毒物药物研究所

出　　处：《中华急诊医学杂志》2002年第4期229-231,235,共4页Chinese Journal of Emergency Medicine

摘　　要：目的　探讨不同剂量HI- 6和阿托品联合呼吸机治疗氧化乐果中毒所致呼吸肌麻痹的疗效。方法　实验大鼠给予 2LD50 的氧化乐果染毒 ,以 1 0mg/kg阿托品对抗胆碱能症状。当大鼠出现呼吸频率减慢、呼吸困难时即行气管插管并辅助机械通气。A组阿托品继续原剂量治疗 ,B、C、D组HI- 6依次按50mg/kg、 80mg/kg、 1 0 0mg/kg于呼吸机治疗即刻及治疗后 1、 2、 3h肌肉注射 ,阿托品减至首剂量的 1 / 3～2 / 3 ,以维持阿托品化为度。经联合治疗 1、 2、 3h后试行脱机 ,以任何一次脱机超过 60min视为联合治疗成功。一次脱机后大鼠存活超过 60min或第 3次脱机后迅速死亡 ,均需取游离膈神经膈肌标本经MS - 30 2生理药理分析仪作膈肌功能测定。结果　A组膈肌功能恢复不佳 ,无一只大鼠脱机成功 ;B、C两组膈肌功能恢复良好 ,3h脱机成功率分别为 80 %和 60 % ,明显高于A组 (P <0 0 1 )。D组膈肌功能测定虽较好 ,但脱机成功率很低。外加乙酰胆碱 (ACh)后 ,B、C、D组膈肌功能均随时间延长而逐渐变小。结论　只有适量HI- 6联合阿托品并辅助呼吸机治疗氧化乐果中毒所致的呼吸肌麻痹 ,才能加速中毒大鼠膈肌功能恢复 。Objective The study was designed to examine the therapeutic effect of combined use of HI-6 and atropine with artificial ventilation on respiratory muscle paralysis caused by omethoate poisoning in rats.Methods Rats were given the same dose of 2LD 50 omethoate and then treated with atropine(10mg/kg) to effectively antagonize chlolinergic symptoms.When the rats had slow respiratory frequency and breathed with difficulty,the trachea was intubated and artificial ventilation was carried out.The rats in group A were continuously treated with atropine.The doses of HI-6 for group B,C,D were 50mg/kg,80mg/kg,100mg/kg respectively,given at the same time as artificial ventilation and 1,2 and 3 hours later.The doses of atropine was reduced to between 1/3 to 2/3 of the first dose so as to maintain the rats atropinized.If the rat survived beyond 60 minutes after withdrawal of artificial ventilation,the combined treatment was considered successful.The function of isolated rats diaphragm was observed with MS-302 instrument to assess diaphragmatic function.Results None of the rats in group A could survive without aftificial ventilation.In group B,C 80% and 60% respectively could be successfully extubated after 3h,function of the diaphragm significantly diffrent from group A( P <0 01).The survival rate in group D was very low after withdrawal,even though the function of the isolated phrenic muscles remained good.The function of the diaphragm in group B,C and D gradually decreased after ACh addition into container.Conclusion The therapeutic effect of combined use of suitable dose of HI-6 and atropine with artificial ventilation on respiratory muscle paralysis caused by omethoate poisoning in rats was significant.This measure can faciliate reversal of the function of poisoned diaphragm

关 键 词：治疗 氧化乐果中毒 呼吸肌麻痹 HI-6 阿托品 呼吸机 动物实验 

分 类 号：R595.4[医药卫生—内科学] R565.3[医药卫生—临床医学]