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目的 :探讨微量注射阿托品 +东莨菪碱治疗急性有机磷中毒 (AOPP)患者的疗效。方法 :重度AOPP住院病人 69例 ,随机分为两组 :①微量泵持续输注阿托品 (CIA) +东莨菪碱组 ,首次静脉推注冲击达阿托品化后 ,采用微量泵持续输注阿托品 +东莨菪碱治疗。②持续静滴阿托品 (CIDA)组 ,采用持续静滴阿托品的方法治疗。结果 :CIA组病人阿托品用量显著少于CIDA组 ,并且心率控制好 ,因阿托品中毒或其它并发症引起的高热病人显著减少 ,抢救成功率明显提高。CIA组病人血清CK -MB、AST、LDH和HBDH数值均明显低于CIDA组。室性早搏、房性早搏、心房颤动、房室传导阻滞、ST段升高或压低事件发生率显著减少 ,发生心衰使用西地兰治疗者CIA明显减少。结论 :阿托品 +东莨菪碱微量注射给药对AOPP患者的心脏损害能起到有效地保护作用。
Objective: To investigate the efficacy of microinjection of atropine + scopolamine in patients with acute organophosphate poisoning (AOPP). Methods: Sixty-nine patients with severe AOPP inpatients were randomly divided into two groups: (1) continuous infusion of atropine (CIA) + scopolamine with micro-pump; the first intravenous bolus injection of datropolizumab followed by continuous infusion of atropine plus scopolamine with a micropump. ② continuous infusion of atropine (CIDA) group, continuous intravenous infusion of atropine treatment. Results: The dosage of atropine in CIA group was significantly less than that in CIDA group, and the control of heart rate was good. The patients with hyperthermia caused by atropine poisoning or other complications were significantly reduced, and the success rate of rescue was significantly improved. The serum CK-MB, AST, LDH and HBDH in CIA patients were significantly lower than those in CIDA patients. Premature ventricular contractions, atrial premature beats, atrial fibrillation, atrioventricular block, ST segment elevation or depression occurred significantly reduced the incidence of heart failure with cedilanid treatment CIA was significantly reduced. Conclusion: Atropine + scopolamine can effectively protect heart from AOPP.