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目的:探讨脂肪乳联合山莨菪碱对百草枯中毒致急性肺损伤(ALI)的预防及治疗作用。方法:选取2012-06-2016-06就诊于我院急诊科的240例百草枯中毒患者的临床资料,按照随机数字表法将上述患者分为A、B、C、D 4组,每组患者各60例。其中A组给予常规治疗,B组给予脂肪乳治疗,C组给予山莨菪碱治疗,D组给予脂肪乳联合山莨菪碱治疗。观察比较4组患者血清IL-6与TNF-α水平、氧合指数(PaO2/FiO2)、ARDS发生率、ICU治疗时间、死亡患者存活时间及治疗有效率等指标。结果:D组治疗后血清IL-6与TNF-α水平低于其他3组,D组PaO2/FiO2高于其他3组,ARDS发生率低于其他3组,ICU治疗时间短于其他3组,死亡患者存活时间长于其他3组,差异有显著统计学意义(P<0.05)。D组治疗的有效率为85%,明显高于A组,差异有统计学意义(P<0.05)。结论:脂肪乳联合山莨菪碱治疗百草枯中毒致ALI的临床效果显著,两药联合有效发挥药物协同作用,有效降低患者血清炎性因子释放,缩短患者ICU治疗时间,提高治疗有效率,值得进一步研究推广。
Objective: To investigate the preventive and therapeutic effects of lipid emulsion combined with anisodamine on acute lung injury (ALI) induced by paraquat poisoning. Methods: The clinical data of 240 paraquat poisoning patients who were treated in our emergency department from June 2012 to June 2016 were selected. According to the random number table, the patients were divided into groups A, B, C and D 4, 60 cases each. Among them, group A received routine treatment, group B received fat emulsion, group C received anisodamine, and group D received combination of fat emulsion and anisodamine. The levels of serum IL-6 and TNF-α, the PaO2 / FiO2, the incidence of ARDS, the duration of ICU, the survival time of patients with death and the treatment effective rate were compared among the four groups. Results: The levels of serum IL-6 and TNF-α in group D were lower than those in the other three groups. PaO2 / FiO2 in group D was higher than the other three groups. The incidence of ARDS was lower than that in the other three groups. ICU treatment time was shorter than the other three groups. The survival of patients died longer than the other three groups, the difference was statistically significant (P <0.05). The effective rate of treatment in group D was 85%, which was significantly higher than that in group A, the difference was statistically significant (P <0.05). Conclusion: The clinical effect of lipid emulsion combined with anisodamine in treating ALI caused by paraquat poisoning is significant. The combination of the two drugs can effectively exert synergistic effect of drugs, effectively reduce the release of serum inflammatory cytokines, shorten the time of ICU treatment and improve the treatment efficiency, which is worth further Research and promotion.