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目的探究阿托品联合盐酸戊乙奎醚治疗急性有机磷农药中毒(AOPP)的临床疗效。方法选取上海市嘉定区中心医院急诊科2013年3月—2014年5月收治的AOPP患者60例,随机分为对照组与观察组,每组30例。对照组给予常规阿托品治疗,观察组给予阿托品联合盐酸戊乙奎醚治疗。比较两组患者治疗前后酰胆碱酯酶(CHE)变化和治疗后毒蕈碱(muscarinic,M)样症状、烟碱(nicotinic,N)样症状、中枢神经(center nerve symptom,CNS)症状、CHE恢复时间以及住院治疗时间。结果两组患者治疗前CHE比较,差异无统计学意义(P>0.05);观察组治疗后3h、6h、12h、24h、48h CHE高于对照组,差异均有统计学意义(P<0.05)。两组患者治疗后M样症状恢复时间、CNS症状恢复时间、CHE恢复时间与住院治疗时间比较,差异均有统计学意义(P<0.05);两组患者N样症状恢复时间比较,差异无统计学意义(P>0.05)。结论阿托品联合盐酸戊乙奎醚治疗AOPP有利于维持阿托品化,患者M样症状恢复时间、CNS症状恢复时间、CHE恢复时间与住院治疗时间均较短。
Objective To investigate the clinical efficacy of atropine combined with penehyclidine hydrochloride in the treatment of acute organophosphorus pesticide poisoning (AOPP). Methods Sixty AOPP patients admitted to Emergency Department of Jiading Central Hospital of Shanghai from March 2013 to May 2014 were randomly divided into control group and observation group, with 30 cases in each group. The control group was given routine atropine treatment, the observation group was given atropine combined with penehyclidine hydrochloride. The change of CHE and the symptoms of muscarinic (M) -like, nicotinic (N) -like, central nervous symptom (CNS) CHE recovery time and hospital treatment time. Results There was no significant difference in CHE between the two groups before treatment (P> 0.05). The CHE in observation group at 3h, 6h, 12h, 24h and 48h after treatment were significantly higher than those in control group (P <0.05) . There were significant differences in recovery time of M symptoms, recovery time of CNS symptoms, CHE recovery time and hospitalization time between the two groups after treatment (P <0.05). There was no statistical difference in N symptom recovery time between the two groups Significance (P> 0.05). Conclusion Atropine combined with Penehyclidine hydrochloride for the treatment of AOPP is conducive to maintaining atropine, patients with M-like symptoms recovery time, CNS symptom recovery time, CHE recovery time and hospitalization time are shorter.