双复磷加阿托品联合呼吸机治疗氧乐果中毒呼吸肌麻痹的疗效  

Study on the therapeutic effect of combined use of obidoxime and atropine with respiratory machine on respiratory muscle paralysis caused by omethoate poisoning of rats

作　　者：邱泽武[1] 赵德禄[2] 史寅奎[1] 黄韶清[1] 

机构地区：[1]军事医学科学院附属307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：《中华劳动卫生职业病杂志》2002年第5期359-361,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的　探讨不同剂量双复磷加阿托品联合呼吸机治疗氧乐果中毒所致呼吸肌麻痹的疗效。方法　实验大鼠均给予 2倍LD50 剂量的氧乐果染毒 ,以 10mg/kg的阿托品对抗胆碱能症状。当大鼠呼吸频率减慢、呼吸困难时即行气管插管并辅助机械通气 ,阿托品 +呼吸机治疗组阿托品继续原剂量治疗 ,阿托品 +呼吸机 +双复磷 8、15、2 0mg/kg组于呼吸机治疗即刻及治疗后 1、2、3h肌内注射双复磷 ,阿托品减至首剂量的 1/3～ 2 /3,以维持阿托品化为度。经联合治疗后 1、2、3h试行脱机 ,若大鼠在上述时间中任何一次脱机超过 6 0min ,则为联合治疗成功。一次脱机后大鼠存活超过 6 0min或第 3次脱机后迅速死亡 ,均取游离膈神经膈肌标本经MS 30 2生理药理分析仪测定膈肌功能。结果阿托品 +呼吸机治疗组大鼠膈肌功能恢复不佳 ,无一只大鼠脱机成功 ;阿托品 +呼吸机 +双复磷 8、15、2 0mg/kg组大鼠膈肌功能均恢复良好 ,3h脱机成功率均在 80 %以上 ,与阿托品 +呼吸机治疗组比较 ,差异均有显著性 (P <0 .0 1)。外加乙酰胆碱 (ACh)后 ,阿托品 +呼吸机 +双复磷 8、15、2 0mg/kg组大鼠膈肌功能均随加ACH后的时间延长而逐渐下降。结论　适量双复磷联合阿托品并辅助呼吸机治疗氧乐果中毒所致的呼吸肌麻痹 ,能加速中毒大鼠膈肌功能恢复 ,降?Objective To examine the therapeutic effect of combined use of obidoxime and atropine with artificial ventilation on respiratory muscle paralysis caused by omethoate poisoning in rats. Methods Rats were exposed to 2 times the dose of LD 50 omethoate and treated with atropine (10 mg/kg) to counteract cholinergic symptoms.When the rats' respiratory frequency became slower and breathed with difficulty,the trachea intubation and artificial ventilation was carried out.The rats in group A were continuously treated with atropine.The dose of obidoxime for Group B?C and D were 8,15,20 mg/kg respectively,given at the same time as artificial ventilation and 1,2,3 hours later.The doses of atropine was reduced to 1/3～2/3 of the first dose so as to maintain the rats atropinized.If the rat survial was beyond 60 minutes after withdrawal of artificial ventilation,the combined treatment was considered successful.The function of isolated phrenic diaphragm of the rats was observed with MS-302 physiological and pharmacological analysis instrument. Results None of the rats in Group A was successful after withdrawal from artificial ventilation and the function of phrenic diaphragm appeared poor;whereas >80% of the rats in B,C,D Group were successful after withdrawal from artificial ventilation in 3 h and the function of phrenic diaphragm remained well.The survival rate in B?C and D groups were higher after withdrawal from artificial ventilation than that in Group A(P<0.01).The function of phrenic diaphragm in Group B,C and D were gradually decreased after ACh was added into the container. Conclusions Combined use of suitable dose of obidoxime and atropine with artificial ventilation for respiratory muscle paralysis caused by omethoate poisoning could promote the recovery of diaphragm function and reduce the death rate in poisoned rats.

关 键 词：疗效 氧乐果中毒 呼吸肌麻痹 双复磷 阿托品 呼吸机 

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