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目的 探讨急性有机磷农药中毒 (AOPP)时抗胆碱药和氯解磷定的用量和用法。方法 AOPP患者 5 2例分为两组 ,阿托品组 2 2例 ,用阿托品 +氯解磷定治疗 ;长效托宁组 3 0例 ,用长效托宁 +氯解磷定治疗 (均肌内注射 )。两组患者分别采用推荐首次用药量 ,再根据胆碱酯酶 (ChE)活力确定重复用药剂量。ChE活力达 5 0 %以上为停药观察指标。结果 阿托品组轻、中、重度中毒患者的阿托品用药总量分别为 ( 11.0± 2 .6)mg、( 2 6.3± 1.6)mg、( 5 4 .3± 1.3 )mg ;氯解磷定用药总量分别为 ( 1.2± 0 .8)g、( 1.9± 1.5 )g、( 3 .2± 0 .9)g;治愈时间分别为 ( 1.8± 0 .3 )d、( 1.9± 0 .6)d、( 3 .5± 0 .5 )d。长效托宁组轻、中、重度中毒患者的长效托宁用药总量分别为 ( 5 .0± 0 .4 )mg、( 9.0± 1.5 )mg、( 10 .0± 0 .3 )mg;氯解磷定用药总量分别为 ( 1.7± 1.0 )g、( 2 .1± 0 .7)g、( 3 .9± 1.2 )g;治愈时间分别为 ( 1.4± 1.5 )d、( 2 .0± 0 .1)d、( 2 .6± 0 .8)d。结论 急性有机磷农药中毒时以抗胆碱药联合应用氯解磷定肌内注射 ,并根据ChE活力结果指导用药 ,方法简单 ,用药总量小 ,治疗效果好。
Objective To investigate the dosage and usage of anticholinergic and chlorophenanthroline in acute organophosphorus pesticide poisoning (AOPP). Methods Fifty-two patients with AOPP were divided into two groups: atropine group (n = 22) and atropine + chlorophenanthroline group (n = 30); long-acting toninolone group injection). Two groups of patients were used for the first time recommended dose, and then determine the dose of repeated use of cholinesterase (ChE) activity. ChE activity of more than 50% for the withdrawal observed indicators. Results The total atropine dosage of atropine group was (11.0 ± 2. 6) mg, (2 6.3 ± 1.6) mg, (54.3 ± 1.3) mg, respectively; (1.2 ± 0.8 g), (1.9 ± 1.5) g, (3.2 ± 0.9) g, and the healing time was (1.8 ± 0.3 days) and (1.9 ± 0.6) days respectively d, (3.5 ± 0.5) d. The total long-acting toning dose of long-acting toning group was (5.0 ± 0.4) mg, (9.0 ± 1.5) mg, (10.0 ± 0.3) mg (1.7 ± 1.0) g, (2.1 ± 0.7) g and (3.9 ± 1.2) g, respectively; the healing time were (1.4 ± 1.5) days and .0 ± 0 .1) d, (2.6 ± 0.8) d. Conclusion Acute organophosphorus pesticide poisoning with anticholinergic drugs combined with chlorpheniramine given intramuscular injection, and based on ChE activity results guide the medication, the method is simple, the total amount of medication is small, the treatment effect is good.