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目的探讨分析重度有机磷中毒患者的临床急救效果。方法选取2013年11月至2015年11月接受治疗的重度有机磷中毒患者90例,将其随机分为对照组和观察组,每组45例,所有患者入院后均立即接受常规插管洗胃、硫酸镁或甘露醇导泻、碘解磷定或氯磷定解毒及血液灌流等基础治疗。除此之外,对照组给予阿托品治疗,观察组给予阿托品联合盐酸戊乙奎醚注射液治疗,分析两组患者的抗胆碱能药物(阿托品、盐酸戊乙奎醚)使用量、胆碱酯酶活力恢复时间、并发症发生率、住院时间方面的差异。结果对照组和观察组患者的抗胆碱能药物总用量分别为(110.08±88.34)、(47.01±19.28)mg,胆碱酯酶活力恢复时间分别为(12.4±6.1)、(7.9±4.1)d,并发症发生率分别为64.44%、22.22%,住院时间分别为(16.2±7.2)、(10.9±5.2)d。两组患者的各项观察指标比较差异均有统计学意义(P<0.05)。结论阿托品联合盐酸戊乙奎醚注射液对于重度有机磷中毒患者的急救治疗能减少抗胆碱能药物使用量、胆碱酯酶活力恢复时间、并发症及住院时间,具有良好的临床效果。
Objective To investigate the clinical emergency treatment of patients with severe organophosphate poisoning. Methods Ninety patients with severe organophosphate poisoning who were treated from November 2013 to November 2015 were selected and randomly divided into control group and observation group with 45 cases in each group. All patients were admitted to regular gastric lavage , Magnesium sulfate or mannitol catharsis, iodine or phosphorus-chlorotitration detoxification and hemoperfusion and other basic treatment. In addition, the control group was treated with atropine, the observation group was given atropine combined with penehyclidine hydrochloride injection, the use of anticholinergic drugs (atropine, penehyclidine hydrochloride), choline ester Enzyme activity recovery time, the incidence of complications, hospital stay differences. Results The total amount of anticholinergic drugs in the control group and observation group were (110.08 ± 88.34) and (47.01 ± 19.28) mg, respectively, and the recovery time of cholinesterase activity were (12.4 ± 6.1) and (7.9 ± 4.1) d. The incidence of complications were 64.44% and 22.22% respectively, and the length of hospital stay was (16.2 ± 7.2) and (10.9 ± 5.2) d, respectively. The two groups of patients with various indicators were statistically significant differences (P <0.05). Conclusion The combination of atropine and penehyclidine hydrochloride for emergency treatment of patients with severe organophosphate poisoning can reduce the usage of anticholinergic drugs, the recovery time of cholinesterase activity, complications and hospital stay, and has a good clinical effect.