论文部分内容阅读
目的:探讨有机磷农药中毒患者阿托品使用方法,提高抢救成功率。方法:对2005年6月至2009年6月我院收治的有机磷农药中毒病人281例进行分组,所有患者均使用阿托品疗法,A组为2007年以后132例序贯阿托品疗法患者,B组2007年以前为常规使用静推继之肌注阿托品疗法149例患者,根据有机磷农药对胆碱酯酶复能剂的疗效分为高效组和低效组,并结合病情严重程度共分为重度有机磷农药中毒胆碱酯酶复能剂高效组、重度有机磷农药中毒胆碱酯酶复能剂低效组,轻度有机磷农药中毒胆碱酯酶复能剂高效组、轻度有机磷农药中毒胆碱酯酶复能剂低效组4组,分别从达到阿托品化时间、维持阿托品化效果、反跳和中间综合征发生率、开始撤药平均时间、总住院费用、总住院平均时间、护士劳动强度进行总结和分析。结果:维持阿托品化疗效A组与B组间有显著差异,P值<0.01,开始撤药平均时间、总住院平均时间、总住院费用、护士劳动强度A组与B组间均有差异,P值<0.05,发生反跳和中间综合征发生率、达到阿托品化时间在高效组间比较无差异,低效组间比较无差异,高效组与低效组比较有显著差异,P值<0.01,主要与中毒药物种类和病情严重程度有关,其次与阿托品治疗方法有关。结论:序贯阿托品疗法治疗有机磷农药中毒优于常规使用静推继之肌注阿托品疗法。
Objective: To investigate the use of atropine in patients with organophosphorus pesticide poisoning to improve the success rate of rescue. Methods: A total of 281 patients with organophosphate pesticide poisoning admitted to our hospital from June 2005 to June 2009 were enrolled. All patients were treated with atropine. Group A was 132 patients with sequential atropine therapy after 2007 and Group B 2007 A year ago for the conventional use of static follow-up intramuscular injection of atropine in 149 patients, according to organophosphorus pesticides on the efficacy of cholinesterase agents into high efficiency group and low efficiency group, combined with the severity of the disease were divided into severe organic Phosphorus pesticide poisoning choline esterase complexing agent high efficiency group, severe organophosphorus pesticide poisoning cholinesterase agent ineffective group, mild organophosphorus pesticide poisoning cholinesterase reactivating agent high efficiency group, mild organophosphorus pesticide Poisoning, cholinesterase agent ineffective group of 4 groups, respectively, from the time to achieve atropine, to maintain the effect of atropine, the incidence of rebound and intermediate syndrome, the average withdrawal time began, the total cost of hospitalization, the total hospital stay, Nurse labor intensity summary and analysis. Results: There was a significant difference between group A and group B in the maintenance of atropine chemotherapy, P <0.01, mean time to start withdrawal, total hospital stay, total hospitalization costs, labor intensity of group A and group B, P Value <0.05, the incidence of rebound and intermediate syndrome occurred, to achieve atropisation time in the high-efficiency group no difference between the ineffective groups no difference between high-efficiency group and low-efficiency group there were significant differences, P value <0.01, Mainly related to the type of poisoning and the severity of the disease, followed by the treatment of atropine. Conclusion: Sequential atropine treatment of organophosphate pesticide poisoning is superior to conventional use of intravenous push followed by intramuscular injection of atropine therapy.