戊乙奎醚與阿托品聯(lián)合應(yīng)用在有機(jī)磷農(nóng)藥中毒治療中的臨床療效觀察

楊春

【摘要】 目的 探討鹽酸戊乙奎醚注射液（商品名：長(zhǎng)托寧）與阿托品聯(lián)合應(yīng)用治療有機(jī)磷農(nóng)藥中毒的臨床療效。方法 60例有機(jī)磷農(nóng)藥中毒患兒， 以隨機(jī)數(shù)字表法分為觀察組和對(duì)照組， 每組30例。觀察組患兒先給予阿托品達(dá)阿托品化后給予戊乙奎醚維持治療， 對(duì)照組患兒?jiǎn)渭兘o予阿托品治療。對(duì)比兩組患兒的急救治療效果及急救指標(biāo)[機(jī)械通氣治療時(shí)間、神志清醒所需時(shí)間、兒童重癥監(jiān)護(hù)病房（PICU）住院時(shí)間、血清膽堿酯酶（CHE）活力恢復(fù)60%時(shí)間、pH值、動(dòng)脈血氧飽和度（SaO2）、動(dòng)脈血氧分壓（PaO2）、動(dòng)脈血二氧化碳分壓（PaCO2）]轉(zhuǎn)歸情況。結(jié)果 觀察組患兒的急救總有效率為93.3%， 高于對(duì)照組的73.3%， 差異具有統(tǒng)計(jì)學(xué)意義 （P<0.05）。觀察組患兒的機(jī)械通氣治療時(shí)間、神志清醒所需時(shí)間、PICU住院時(shí)間、CHE活力恢復(fù)60%時(shí)間均短于對(duì)照組， pH值、PaCO2低于對(duì)照組， SaO2、PaO2高于對(duì)照組， 差異均具有統(tǒng)計(jì)學(xué)意義 （P<0.05）。結(jié)論 戊乙奎醚與阿托品聯(lián)合應(yīng)用治療有機(jī)磷農(nóng)藥中毒可顯著提高患兒的急救成功率， 對(duì)患兒的各項(xiàng)急診急救指標(biāo)的轉(zhuǎn)歸具有顯著的促進(jìn)作用。

【關(guān)鍵詞】 戊乙奎醚；阿托品；有機(jī)磷農(nóng)藥中毒

DOI：10.14163/j.cnki.11-5547/r.2017.25.068

【Abstract】 Objective To investigate the clinical efficacy of penehyclidine hydrochloride injection （trade name： Changtuoning） combined with atropine in the treatment of organophosphorus pesticide poisoning. Methods A total of 60 organophosphorus pesticide poisoning children were divided by random number table method into observation group and control group， with 30 cases in each group. The observation group received atropine first then penehyclidine maintenance therapy after “atropinization”， and the control group received only atropine. Comparison were made on emergency treatment effect and emergency indexes [mechanical ventilation time， conscious time， pediatric intensive care unit （PICU） hospitalization time， serum cholinesterase （CHE） activity recovered 60% time， pH value， arterial oxygen saturation （SaO2）， arterial oxygen pressure （PaO2） and arterial partial pressure of carbon dioxide （PaCO2）] outcome in two groups. Results The observation group had higher total emergency effective rate as 93.3% than 73.3% in the control group， and their difference had statistical significance （P<0.05）. The observation group had shorter mechanical ventilation time， conscious time， PICU hospitalization time and CHE activity recovered 60% time than the control group， lower pH value and PaCO2 than the control group and higher SaO2 and PaO2 than the control group. Their difference had statistical significance （P<0.05）. Conclusion Combination of penehyclidine and atropine in treating organophosphorus pesticide poisoning can significantly improve the emergency success rate of children， and it has a significant effect in promoting the outcome of emergency first aid indicators in children.

【Key words】 Penehyclidine； Atropine； Organophosphorus pesticide poisoning

有機(jī)磷農(nóng)藥中毒是急診臨床中最常見(jiàn)的一種農(nóng)藥中毒現(xiàn)象， 患兒一旦發(fā)生有機(jī)磷農(nóng)藥中毒會(huì)由于呼吸肌麻痹、呼吸中樞抑制、肺水腫等原因而造成呼吸衰竭， 最終導(dǎo)致死亡[1]。有機(jī)磷農(nóng)藥中毒患兒具有情況危急、中毒進(jìn)展較快的臨床特征[2]。因此， 對(duì)有機(jī)磷農(nóng)藥中毒患兒及時(shí)給予積極有效的救治十分重要[3]。本院聯(lián)合應(yīng)用戊乙奎醚與阿托品治療有機(jī)磷農(nóng)藥中毒， 收取了良好的治療效果， 以下對(duì)整個(gè)研究過(guò)程進(jìn)行報(bào)告， 以期為臨床積極進(jìn)行有機(jī)磷農(nóng)藥中毒患兒的救治提供幫助。endprint

1 資料與方法

1. 1 一般資料 采取方便抽樣法抽取60例于2012年6月～

2017年4月以急診方式來(lái)本科室進(jìn)行急救治療的有機(jī)磷農(nóng)藥中毒患兒， 以隨機(jī)數(shù)字表法分為觀察組和對(duì)照組， 每組30例。……