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目的 探讨突击量氯磷定对急性有机磷农药中毒 (AOPP)所致中间综合征 (IMS)的防治作用。方法 将 2 4 4例重度AOPP分为A、B两组。A组在治疗开始即采用突击量氯磷定治疗 ;B组开始给予常规量解磷定 ,在患者出现前驱症状后又分为C、D两组 ,C组给予突击量氯磷定治疗 ,方法同前 ;D组仍维持原治疗方案。结果 A、B两组患者在前驱症状发生率、呼吸肌麻痹 (RMP)发生率及病死率方面均具有统计学差异 (P <0 0 1)。整个疗程中A组阿托品用量明显低于B组 (P <0 0 1)。B组患者 14 6例出现前驱症状 ,其中C组 112例 ,发生RMP者 5 8例 (5 1 8% ) ,D组 34例 ,发生RMP者 2 8例 (82 4 % ) ,两组差异具有统计学意义 ,(P <0 0 1) ;C组存活者机械通气时间较D组明显缩短 (P <0 0 1)。结论 突击量氯磷定不仅可以减少IMS的发生 ,而且对出现RMP者还可缩短机械通气时间 ,大大提高IMS治愈率 ,对IMS具有明确的防治作用。
Objective To investigate the prevention and treatment of intermediate dose of phosphorus (AP) induced by acute organophosphorus pesticide poisoning (AOPP). Methods 244 cases of severe AOPP were divided into A and B groups. A group at the beginning of treatment that is treated with the impact of chlorphenesin; B group began to give the conventional amount of phosphate solution, in patients with prodromal symptoms and then divided into C, D two groups, C were given the amount of blistering treatment, the method Same as before; D group still maintain the original treatment plan. Results The incidence of prodromes, respiratory muscle paralysis (RMP) and mortality in both groups A and B were statistically different (P <0.01). The amount of atropine in group A was significantly lower than that in group B during the course of treatment (P <0.01). There were 146 cases of group B with prodromal symptoms, including 112 cases in group C, 58 cases (51.8%) in RMP, 34 cases in group D, and 28 cases (82.4%) in group RMP. There were significant differences between the two groups (P <0.01). The mechanical ventilation time of survivors in group C was significantly shorter than that in group D (P <0.01). Conclusions The dose of chlorophosphonam can not only reduce the occurrence of IMS, but also shorten the time of mechanical ventilation to RMP and greatly improve the cure rate of IMS, which has a clear preventive and therapeutic effect on IMS.