摘要
目的探讨纳洛酮联合盐酸戊乙奎醚注射液治疗急性有机磷类毒物中毒的疗效和对血清生化和预后的影响。方法纳入2015年12月至2018年12月我院急诊收治的70例急性有机磷类毒物中毒患者,按入院时间顺序分为对照组(n=37)和观察组(n=33)。对照组在清洗体表、洗胃、导泻、保持呼吸通畅、快速创建静脉通道、纠正酸碱平衡及水电解质紊乱等常规治疗基础上联合盐酸戊乙奎醚注射液,观察组在对照组治疗基础上加用纳洛酮,比较两组临床疗效、指标恢复时间、治疗前后胆碱酯酶(cholinesterase,ChE)、血常规、心肌酶谱、不良反应及预后情况。结果观察组(87.88%)总有效率高于对照组(64.86%,P<0.05)。观察组中毒症状消失时间、ChE活力恢复时间及住院时间均少于对照组(P<0.05)。治疗前,两组ChE、红细胞参数、血小板参数、白细胞计数、中性粒细胞比例及心肌酶谱指标比较差异无统计学意义(P>0.05);治疗后,两组ChE均较治疗前上升,红细胞参数、血小板参数、白细胞计数、中性粒细胞比例和心肌酶谱指标均下降(P<0.05);组间比较显示,治疗后,观察组ChE水平高于对照组,红细胞参数、血小板参数、白细胞计数、中性粒细胞比例及心肌酶谱指标低于对照组(P<0.05)。两组总不良反应发生率比较,差异无统计学意义(P>0.05)。观察组病死率低于对照组(P<0.05)。结论纳洛酮联合盐酸戊乙奎醚注射液可提高急性有机磷中毒的疗效,明显改善红细胞、血小板参数,降低病死率。
Objective To investigate the treatment effect of naloxone combined with penehyclidine hydrochloride injection for the treatment of acute organophosphorus pesticide poisoning and its influence on serum biochemistry and prognosis.Methods During December 2015 and December 2018,a total of 70 patients with acute organophosphorus pesticide poisoning were recruited and divided into control group(n=37) and observation group(n=33).Patients in the control group were given penehyclidine hydrochloride injection along with the routine treatment such as cleaning the body surface,gastric lavage,catharsis,keeping breathing unobstructed,quickly creating venous channels,correcting acid-base balance and water electrolyte disorder,while patients in the observation group were given additional naloxone on the basis of treatment in control group.The clinical efficacy,index recovery time,cholinesterase(ChE),blood routine test,myocardial enzyme spectrum,adverse reactions and prognosis before and after treatment were compared.Results The total effective rate of the observation group(87.88%) was higher than that of the control group(64.86%,P<0.05).The disappearance time of poisoning symptoms,the recovery time of ChE activity and hospitalization time in the observation group were less than those in the control group(P<0.05).Before treatment,there was no significant difference in ChE,red blood cell parameters,platelet parameters,white blood cell count,proportion of neutrophils and myocardial enzyme spectrum indexes between the two groups (P>0.05).But after the treatment,the ChE groups were increased,red blood cell parameters,platelet parameters,white blood cell count,proportion of neutrophils were decreased in both groups(P<0.05).After treatment,the ChE level in the observation group was higher than that in the control group,while the red blood cell parameters,platelet parameters,white blood cell count,neutrophil proportion and myocardial enzyme spectrum indexes were lower than those in the control group (P<0.05).There was no significant difference in the adverse reaction rate between the two groups (P>0.05).The mortality in observation group was lower than that in control group(P<0.05).Conclusion Naloxone combined with penehyclidine hydrochloride injection could improve the curative effect of acute organophosphorus pesticide poisoning,as well as the parameters of red blood cells and platelets parameters,and reduce the mortality rate.
作者
张保金
高德军
ZHANG Bao-jin;GAO De-jun(Department of Emergency,the Second People's Hospital of Liaocheng,Liaocheng 252600,Shandong Province,China)
出处
《世界临床药物》
CAS
2020年第11期891-896,909,共7页
World Clinical Drug
关键词
急性有机磷类毒物中毒
纳洛酮
盐酸戊乙奎醚注射液
生化指标
预后
acute organophosphorus pesticide poisoning
naloxone
penehyclidine hydrochloride injection
biochemical indicators
prognosis
