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1.
有机磷农药中毒治疗中抗胆碱药与氯解磷定的联合应用   总被引:2,自引:0,他引:2  
目的探讨急性有机磷农药中毒(AOPP)时抗胆碱药和氯解磷定的用量和用法.方法 AOPP患者52例分为两组,阿托品组22例,用阿托品+氯解磷定治疗;长效托宁组30例,用长效托宁+氯解磷定治疗(均肌内注射).两组患者分别采用推荐首次用药量,再根据胆碱酯酶(ChE)活力确定重复用药剂量.ChE活力达50%以上为停药观察指标.结果阿托品组轻、中、重度中毒患者的阿托品用药总量分别为(11.0±2 6)mg、(26.3±1.6)mg、(54.3±1.3)mg;氯解磷定用药总量分别为(1.2±O.8)g、(1.9±1.5)g、(3.2±0.9)g;治愈时间分别为(1.8±0.3)d、(1.9±0.6)d、(3.5±O.5)d.长效托宁组轻、中、重度中毒患者的长效托宁用药总量分别为(5.0±0.4)mg、(9.0±1.5)mg、(10.O±O.3)mg;氯解磷定用药总量分别为(1.7±1.0)g、(2.1±O.7)g、(3.9±1.2)g;治愈时间分别为(1.4±1.5)d、(2.0±0.1)d、(2.6±0.8)d.结论急性有机磷农药中毒时以抗胆碱药联合应用氯解磷定肌内注射,并根据ChE活力结果指导用药,方法简单,用药总量小,治疗效果好.  相似文献   

2.
长托宁与阿托品治疗急性有机磷杀虫药中毒的疗效比较   总被引:1,自引:0,他引:1  
目的观察长托宁与阿托品治疗急性有机磷杀虫药中毒(AOPP)的疗效。方法用长托宁配合氯磷定治疗35例AOPP患者,并与阿托品配合氯磷定治疗37例AOPP患者进行比较。结果长托宁组较阿托品组患者M样症状及中枢神经系统症状消失快、用药次数少、用药剂量小、住院时间短、不良反应发生率低,差异有统计学意义(P〈0.05),而死亡率无明显差异。结论长托宁对抗AOPP患者的中枢神经系统症状快于阿托品,对心血管系统的副作用少于阿托品,应作为治疗AOPP的首选抗胆碱能药物。  相似文献   

3.
目的 探析长托宁与氯解磷啶联合方式在AOPP(有机磷农药中毒)治疗中的疗效,为临床在治疗AOPP中合理安全用药提供参照.方法 2008年7月-2013年7月我科收治的73例AOPP患者,39例(研究组)采用长托宁与氯解磷啶联合方式,34例(对照组)采用阿托品与氯解磷啶联合方式,对比两组临床基本情况、综合疗效以及并发症情况.结果 在CHE的恢复时间、患者清醒时间以及中毒症状的消失时间3项对照指标上,研究组患者用时均明显更少;研究组治愈率91.4%,死亡率3.7%;对照组治愈率69.2%,死亡率21.8%;研究组发生阿托品中毒、反跳以及中间综合征等并发症的几率均明显更少,且对照组中同时出现2例迟发型神经疾病患者(3.8%);研究组效果明显更理想(P<0.05).结论 长托宁与氯解磷啶联合方式在AOPP治疗中,疗效显著,且毒副作用小,是一种安全理想的治疗方式,值得推广应用.  相似文献   

4.
动态观察胆碱酯酶活力与抗胆碱药的应用   总被引:1,自引:0,他引:1  
为探讨治疗急性有机磷农药中毒 (AOPP)时抗胆碱药的用量、用法与动态胆碱酯酶 (ChE)活力的关系 ,我们对应用抗胆碱新药长效托宁与阿托品治疗的口服中毒患者进行了对比观察。1.对象与方法 :长效托宁组为 5 7例AOPP患者 (男 16例、女 41例 ,平均年龄 31 3岁 ) ,其中轻度中毒 12例、中度 34例、重度 11例。轻、中、重度患者首次长效托宁分别为 1~ 2、2~ 4和 4~ 6mg/人 ,氯磷定分别为 0、10 0 0~ 15 0 0和 15 0 0~2 5 0 0mg/人 ;重复用长效托宁分别为 0、1~ 2和 2~ 3 (mg/人 ) ,氯磷定分别为 0、5 0 0~ 10 0 0和 10 0 …  相似文献   

5.
目的观察盐酸戊乙奎醚(长托宁)治疗急性有机磷农药中毒(AOPP)的临床疗效。方法选择笔者所在医院自2007年1月~2009年1月接诊的以长托宁+氯磷定治疗的60例AOPP患者作为治疗组,自2005年1月~2007年1月接诊的以阿托品+氯磷定治疗的76例AOPP患者作为对照组,对两组患者的毒蕈碱样(M样)症状消失时间、药物不良反应发生率、胆碱酯酶恢复60%时间、住院时间等指标进行比较分析。结果治疗组患者的M样症状消失快,药物的不良反应发生率低,胆碱酯酶(ChE)恢复60%时间短,平均住院时间缩短。结论长托宁目前是治疗AOPP的理想抗胆碱药。  相似文献   

6.
目的 探讨长托宁伍用氯磷定治疗有机磷中毒,在住院天数、症状消失时间、反跳率、死亡率、治愈率方面明显优于阿托品伍用解磷定组。方法 选择不同时间段所有中毒患者Ⅰ组36例,Ⅱ组18例,Ⅰ组采用阿托品解磷定,Ⅱ组长托宁氯磷定。结果 Ⅱ组较Ⅰ组住院天数、症状消失时间、反跳率、死亡率、治愈率方面有明显差异性(P〈0.01)。结论 有机磷中毒的治疗,用长托宁伍用氯磷定,具有全面抗M样症状、N样症状、中枢神经系统中毒症状。且氯磷定较解磷定性质稳定,水溶性好。  相似文献   

7.
目的 探讨小儿急性有机磷农药中毒(AOPP)现场系统救治的可行性,比较长托宁与阿托品院前急救小儿AOPP的疗效.方法 39例小儿AOPP病例,其中长托宁治疗组19例,阿托品对照组20例,两组均联合使用氯磷定.观察两组生存率;存活儿童ChE恢复时间、平均用药次数、平均住院日、中毒症状消失时间及药物不良反应.结果 治疗组及对照组生存率分别为947%、90%;两组存活儿童出汗、流涎、肺部啰音、瞳孔缩小等症状消失时间,口干、高热发生率比较差异无统计学意义(P〉005),但治疗组ChE恢复时间、平均用药次数、平均住院日、昏迷持续时间、心动过速及躁动发生率与对照组比较,差异有统计学意义(P〈005).结论 院前救治AOPP切实可行,长托宁是抢救小儿AOPP较理想的抗胆碱药物.  相似文献   

8.
目的观察分析盐酸戊乙奎醚联合阿托品治疗治疗急性有机磷农药中、重度中毒的临床效果。方法对2015年3月—2019年2月收治的86例患者随机分为观察组和对照组,每组43例。对照组给予阿托品、氯解磷定治疗;观察组给予盐酸戊乙奎醚、阿托品和氯解磷定联合治疗;并观察患者中毒症状消失、阿托品化、胆碱酯酶(cholinesterase,ChE)活性恢复时间及并发症。结果观察组中毒症状消失、阿托品化、胆碱酯酶活度恢复及住院时间均较对照组缩短,有统计学意义(P<0.05);不良反应:观察组2例,占4.65%;对照组7例,占16.28%。两组比较有统计学意义(P<0.05)。结论盐酸戊乙奎醚联合阿托品、氯解磷定治疗治疗急性有机磷农药中、重度中毒可缩短症状消失、阿托品化、胆碱酯酶活度恢复时间及住院天数,降低不良反应发生率。  相似文献   

9.
目的观察长托宁治疗小儿有机磷中毒的疗效。方法将50例有机磷中毒患儿随机分成2组。观察组使用长托宁加氯解磷定,对照组常规使用阿托品和氯解磷定。结果观察组治愈率高,病程短,疗效好,不良反应小。结论长托宁是一种治疗小儿急性有机磷农药中毒的长效抗胆碱药,安全、高效,不良反应少。  相似文献   

10.
目的观察长托宁取代阿托品在治疗有机磷农药中毒中的疗效。方法选择79例有机磷农药中毒患者随机分组,采用长托宁加氯解磷定与阿托品加氯解磷定传统治疗方法进行对照,治疗过程中对其疗效进行临床观察。结果治疗组与对照组在用药次数、胆碱酯酶恢复时间、起效时间、症状消失时间及抢救成功率差异有显著性(P〈0.01)。结论长托宁治疗有机磷农药中毒有病程短、疗效好、治愈率高。  相似文献   

11.
Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.  相似文献   

12.
This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.  相似文献   

13.
深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.  相似文献   

14.
Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO2) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO2. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO2 at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO2 gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO2 also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO2.  相似文献   

15.
The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.  相似文献   

16.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L?1 to a maximum of 79?mg·L?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.  相似文献   

17.
Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).  相似文献   

18.

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.  相似文献   

19.
20.
The repeatability and validity of a questionnaire for upper limb and neck complaints were assessed in a population of 105 hospital outpatients with a range of upper limb and neck disorders (including cervical spondylosis, adhesive capsulitis, lateral epicondylitis, carpal tunnel syndrome and Raynaud's phenomenon). Subjects were asked to complete a modified Nordic-style upper limb and neck discomfort questionnaire on two occasions closely spaced in time. The repeatability of their responses was assessed by calculating a kappa coefficient (kappa), and the sensitivity and specificity of component items in the questionnaire were determined for specific diagnostic categories of upper limb and neck disorder. Symptom reports for pain in the upper limb and neck, pain interfering with physical activities, neurological symptoms and blanching were all found to be highly repeatable (kappa = 0.63-0.90). A number of regional pain reports proved to be very sensitive in relation to specific upper limb disorders, but, with the exception of reported finger blanching in patients with Raynaud's phenomenon, none proved to have a good specificity (range = 0.33-0.38). We conclude that a modified Nordic-style questionnaire is repeatable and sensitive, and is likely to have a high utility in screening and surveillance. However a complementary examination schedule of adequate specificity and repeatability is essential to establish a clinical diagnosis.  相似文献   

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