快速阿托品化联合碘解磷定复能在有机磷中毒院前急诊中的应用效果观察被引量：7

Practical effect of rapid atropinization combined with pralidoxime iodide in pre-hospital emergency of organophosphorus poisoning

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摘要目的研究有机磷中毒院前急诊中快速阿托品化联合碘解磷定复能的应用价值。方法68例有机磷中毒患者,采用随机数字表法分为观察组及对照组,每组34例。两组患者均接受快速阿托品化治疗,观察组在此基础上联合碘解磷定复能治疗。对比两组院前急救时间、血清胆碱酯酶恢复时间、中毒症状(烟碱样症状及毒蕈碱样症状)消失时间,阿托品总量、阿托品化时间,治疗期间不良事件发生情况,抢救成功率以及住院时间。结果两组院前急救时间对比,差异无统计学意义(P>0.05);观察组血清胆碱酯酶恢复时间(6.59±0.54)h、烟碱样症状消失时间(9.90±0.76)h、毒蕈碱样症状消失时间(2.77±0.33)h短于对照组的(8.40±0.65)、(12.20±1.03)、(5.18±0.45)h,差异有统计学意义(P<0.05)。观察组阿托品总量(20.01±2.22)mg低于对照组的(38.12±3.44)mg,阿托品化时间(1.09±0.16)h短于对照组的(2.99±0.33)h,差异有统计学意义(P<0.05)。观察组治疗期间不良事件发生率5.88%低于对照组的35.29%,差异有统计学意义(P<0.05)。两组抢救成功率对比,差异无统计学意义(P>0.05);观察组住院时间(10.40±0.54)d短于对照组的(13.30±1.10)d,差异有统计学意义(P<0.05)。结论在有机磷中毒院前急诊中应用快速阿托品化联合碘解磷定复能治疗,可有效缩短院前急救时间以及中毒症状改善时间,并能促进血清胆碱酯酶指标恢复,效果显著。 Objective To study the practical effect of rapid atropinization combined with pralidoxime iodide in pre-hospital emergency of organophosphorus poisoning.Methods A total of 68 patients with organophosphorus poisoning were divided into observation group and control group according to random numerical table,with 34 cases in each group.Both groups were treated with rapid atropinization,and the observation group was also treated with pralidoxime iodide.The pre-hospital emergency time,recovery time of serum cholinesterase,disappearance time of poisoning symptoms(nicotinic symptoms and muscarinic symptoms),total amount of atropine,atropineization time,occurrence of adverse events during treatment,success rate of rescue,and hospitalization time were compared between the two groups.Results There was no statistically significant difference in pre-hospital emergency time between the two groups(P>0.05).The recovery time of serum cholinesterase(6.59±0.54)h,disappearance time of nicotinic symptoms(9.90±0.76)h disappearance time of muscarinic symptoms(2.77±0.33)h of the observation group were shorter than(8.40±0.65),(12.20±1.03)and(5.18±0.45)h of the control group,and the difference was statistically significant(P<0.05).The total amount of atropine(20.01±2.22)mg was lower than(38.12±3.44)mg of the control group,and atropineization time(1.09±0.16)h was shorter than(2.99±0.33)h of the control group.All the difference was statistically significant(P<0.05).The incidence of adverse events during treatment 5.88%of the observation group was lower than 35.29%of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in success rate of rescue between the two groups(P>0.05).The hospitalization time(10.40±0.54)d of the observation group was shorter than(13.30±1.10)d of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of rapid atropinization and pralidoxime iodide shows remarkable effect in pre-hospital emergency of organophosphorus poisoning,which can effectively shorten pre-hospital emergency time and disappearance time of poisoning symptoms,and promote the recovery of serum cholinesterase.