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目的:观察长托宁联合纳洛酮治疗小儿重度有机磷农药中毒的的疗效。方法:选取2011年9月-2014年3月我院收治的98例重度有机磷农药中毒患儿,按照随机数字表将患儿分为常规治疗组(n=49)和联合治疗组(n=49),常规治疗组用阿托品联合氯磷定治疗,联合治疗组用长托宁联合纳洛酮治疗。对比两组中毒症状消失时间、胆碱酯酶活力恢复时间、意识恢复时间、住院时间、病死率及治疗前后心肌酶谱水平。结果:联合治疗组的中毒症状消失时间、胆碱酯酶活力恢复时间、意识恢复时间、住院时间均显著短于对照组(P<0.01),联合治疗组的病死率也显著降低(P<0.01)。两组治疗后心肌酶谱均显著下降(P<0.01),且联合治疗组下降更为明显(P<0.01)。结论:长托宁联合纳洛酮联合治疗小儿中毒有机磷农药中毒疗效显著,能缩短病程,降低病死率,改善预后。
Objective: To observe the effect of combination of penehyclidine hydrochloride and naloxone on severe organophosphorus pesticide poisoning in children. Methods: A total of 98 children with severe organophosphorus pesticide poisoning admitted to our hospital from September 2011 to March 2014 were selected and randomly divided into the treatment group (n = 49) and the combination therapy group (n = 49). The conventional treatment group was treated with atropine and chlorophosphorus, while the combination therapy group was treated with penehyclidine and naloxone. The time of disappearance of symptoms of poisoning, the recovery time of cholinesterase activity, the recovery time of consciousness, the length of hospital stay, the mortality rate and the level of myocardial enzymes before and after treatment were compared. Results: The disappearance time of poisoning symptoms, recovery time of cholinesterase activity, consciousness recovery time and hospital stay in the combined treatment group were significantly shorter than those in the control group (P <0.01), and mortality in the combined treatment group was significantly lower (P <0.01) ). The myocardial enzymes of both groups were significantly decreased (P <0.01), and the combined treatment group decreased more significantly (P <0.01). Conclusion: The combination of penehyclidine and naloxone in the treatment of organophosphorus pesticide poisoning in children has significant curative effect, which can shorten the course of disease, reduce the mortality and improve the prognosis.