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目的:探讨长托宁、阿托品联合血液灌流治疗急性有机磷中毒伴呼吸衰竭的临床疗效。方法:选取2009年1月至2016年8月在我院治疗的重症有机磷农药中毒伴呼吸衰竭患者68例,随机分为2组,A组35例,B组33例,A组患者接受长托宁联合阿托品常规治疗,B组患者接受长托宁、阿托品联合血液灌流治疗。比较两组患者治疗期间血清乙酰胆碱酶、肌酸激酶的含量以及治疗情况、临床疗效,同时记录治疗期间不良反应的发生情况。结果:治疗期间,B组患者血清Ach E的含量显著高于A组患者(P<0.05),血清CK含量显著低于A组患者(P<0.05);B组患者的清醒时间、到达阿托品化时间、中毒症状消失时间以及住院时间显著低于A组患者(P<0.05);B组患者的病死率以及不良反应的发生率显著低于A组(P<0.05);B组患者治疗的总有效率显著高于A组(P<0.05)。结论:长托宁、阿托品联合血液灌流可以显著缓解急性有机磷中毒伴呼吸衰竭患者体内胆碱能紊乱的状态,提高临床疗效,并且有效降低治疗期间不良反应的发生率。
Objective: To investigate the clinical effect of combined treatment of long-acting and atropine hemoperfusion on acute organophosphate poisoning and respiratory failure. Methods: Sixty-eight patients with severe organophosphorus pesticide poisoning and respiratory failure who were treated in our hospital from January 2009 to August 2016 were randomly divided into two groups: 35 cases in group A, 33 cases in group B, Tonic combined with atropine conventional treatment, B group received long-Toning, atropine combined with hemoperfusion treatment. The serum levels of acetylcholine and creatine kinase during treatment were compared between the two groups, as well as the treatment, clinical efficacy, and the incidence of adverse reactions during the treatment. Results: During the treatment, serum Ach E level in group B was significantly higher than that in group A (P <0.05), serum CK was significantly lower than that in group A (P <0.05); group B was awake for atropine (P0.05). The mortality and the incidence of adverse reactions in group B were significantly lower than those in group A (P0.05). The total treatment time in group B was significantly lower than that in group A The effective rate was significantly higher than the A group (P <0.05). Conclusion: The combination of penehyclidine hydrochloride and atropine can significantly alleviate the cholinergic disorder in patients with acute organophosphate poisoning and respiratory failure, improve the clinical curative effect, and effectively reduce the incidence of adverse reactions during the treatment.