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目的:探讨阿托品与长托宁联合治疗重度急性有机磷农药中毒(AOPP)的疗效。方法:将2013-07-2016-07入住我院重症医学科的重度AOPP患者随机分为A组(阿托品治疗组)、B组(长托宁治疗组)及C组(联合治疗组),每组各36例。动态观察患者胆碱酯酶(CHE)活力,记录其住院时间、中间综合征和不良反应例数,统计各组的治愈率。结果:1A组、B组及C组的CHE活力恢复70%时间分别为(101.86±9.2)h、(80.38±9.37)h、(74.66±7.25)h,3组的住院时间分别为(13.11±2.48)d、(12.07±1.63)d、(9.76±1.80)d;C组的CHE活力恢复70%时间及住院时间较A组、B组缩短,且B组较A组缩短,差异均有统计学意义(均P<0.05)。2C组的中间综合征及不良反应发生率较A组明显降低,其治愈率上升;B组的不良反应发生率较A组明显降低,差异均有统计学意义(均P<0.01)。其他组间比较差异无统计学意义。结论:阿托品联合长托宁治疗重度AOPP患者的疗效明显优于阿托品及长托宁单独治疗组,缩短了CHE活力恢复70%时间及住院时间,减少了阿托品所带来的并发症,提高治愈率。
Objective: To investigate the curative effect of combination of atropine and penehyclidine on severe acute organophosphorus pesticide poisoning (AOPP). Methods: Patients with severe AOPP admitted to our hospital from July 2013 to June 2016 were randomly divided into group A (atropine treatment group), group B (penehyclidine hydrochloride treatment group) and group C (combination treatment group) Group of 36 cases. Cholinesterase (CHE) activity was observed dynamically. The length of hospital stay, intermediate syndrome and adverse reactions were recorded. The cure rate of each group was calculated. Results: The recovery time of CHE in group 1A, group B and group C were (101.86 ± 9.2) h and (80.38 ± 9.37) h and (74.66 ± 7.25) h respectively, and the hospital stay time in group A and group C were (13.11 ± 2.48) d, (12.07 ± 1.63) d and (9.76 ± 1.80) d, respectively. The recovery of CHE activity in group C was 70% longer than that in group A and group B, and was shorter in group B than in group A Significance (both P <0.05). The incidence of intermediate syndrome and adverse reactions in group 2C was significantly lower than that in group A, and the cure rate was increased. The incidence of adverse reactions in group B was significantly lower than that in group A (all P <0.01). No significant difference between the other groups. Conclusions: The efficacy of atropine combined with penehyclidine in patients with severe AOPP is significantly better than that of atropine and penehyclidine alone, which can shorten the recovery time of CHE by 70% and hospital stay, reduce the complications caused by atropine and improve the cure rate .