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目的探讨突击量氯解磷定治疗方案在重度急性有机磷农药中毒(AOPP)救治中的临床疗效。方法将符合重度AOPP的96例患者随机分为突击量氯解磷定治疗方案组(A组)48例和常规剂量氯解磷定治疗组(B组)48例。A组:在常规治疗的基础上应用突击量氯解磷定治疗方案;B组:在常规治疗基础上加常用量氯解磷定治疗。治疗后比较2组间阿托品用量、阿托品化时间、胆碱酯酶活性(Ch E)动态变化、住院时间、中间综合征(IMS)发生率、病死率和不良反应(呼吸衰竭、心肝肾脑损害、代谢性酸中毒)发生率。结果 A组救治过程中阿托品总用量明显少于B组IMS发生率、病死率明显低于B组(P<0.05),阿托品化时间、住院时间明显短于B组(P<0.05),入院治疗24,48,72 h时A组Ch E变化低于B组(P<0.05);A组其他不良反应明显少于B组(P<0.05)。结论治疗重度AOPP时应用突击量氯解磷定治疗方案,可明显减少阿托品的使用量,加速阿托品化,迅速恢复Ch E活性,降低IMS发生率及减少其他不良反应,缩短患者住院时间,提高临床疗效。
Objective To investigate the clinical efficacy of the randomized treatment of ambroxol in the treatment of severe acute organophosphorus pesticide poisoning (AOPP). Methods Ninety-six patients with severe AOPP were randomly divided into two groups: 48 cases in group A (treated with amoxicillin) and 48 cases in group B (conventional dose chlorpromazine). Group A: The routine treatment based on the application of the impact of chlorpromazine treatment; Group B: on the basis of conventional therapy plus chlorfluazuron treatment. After treatment, the amounts of atropine, atropine, cholinesterase activity (ChE), length of hospital stay, incidence of intermediate syndrome (IMS), mortality and adverse reactions (respiratory failure, Damage, metabolic acidosis) incidence. Results The total consumption of atropine in group A was significantly less than that in group B, and the mortality was significantly lower than that in group B (P <0.05). The time of atropisation and hospital stay were significantly shorter than those in group B (P <0.05) The changes of Ch E in group A were lower than those in group B at 24, 48 and 72 h (P <0.05). The other adverse reactions in group A were significantly less than those in group B (P <0.05). Conclusions The treatment of severe AOPP with the application of the randomized dose of chlorprovidine can significantly reduce the amount of atropine, accelerate the administration of atropine, rapidly restore the activity of ChE, reduce the incidence of IMS and other adverse reactions, shorten the hospitalization time and improve the clinical Efficacy.