氯磷定持续泵入对急性毒死蜱中毒的疗效分析

目的探讨氯磷定在急性毒死蜱中毒中的应用方法。方法将20例急性毒死蜱中毒患者分A组和B组。A组给予彻底清除毒物,尽早应用阿托品等常规治疗,氯磷定采用传统的反复肌肉注射法;B组氯磷定采用微量泵持续泵入法,其余治疗同A组。比较各组患者的临床疗效和治疗7d内血清胆碱脂酶的活性变化。结果 A组的阿托品总用量、阿托品中毒发生率、反跳率和平均住院天数明显高于B组(P<0.01),而B组的氯磷定总用量显著多于A组(P<0.01)。治疗7d内,B组血清胆碱酯酶活性恢复显著快于A组(P<0.01)。结论急性毒死蜱中毒的救治中,增加氯磷定日总量,采用静脉持续泵入,延长用药时间,经观察疗效明显,用药安全。

Therapeutic Efficacy of Pralidoxime Chloride by Continuous Intravenous Infusion in Treatment of Acute Chlorpyrifos Poisoning

Objective To evaluate the efficacy of pralidoxime chloride by continuous intravenous infusion in treatment of acute chlorpyrifos poisoning. Methods 20 patients with acute chlorpyrifos poisoning were enrolled and divided into A group and B group. In A group, pralidoxime chloride was given by intramuscular injection at regular intervals; in B group, pralidoxime chloride was used continually by syringe pump. All patients accepted traditional treatment including gastric lavage, catharsis, emetic and atropine. The clinical efficacy and cholinesterase activity were compared between groups. Results In A group, the cumulative dosage of atropine and the frequency of atropine poisoning and intoxicated rebound and average hospitalization days were significantly higher than those in B group （P〈 0.01 ） . The cumulative dosage of pralidoxime chloride in B group was markedly higher than that in A group （P〈 0.01 ） . The cholinesterase activities determined after 7 days treatment in B group were significantly higher than A group＇s at the same time （P 0.01 ） . Conclusion There was remarkably therapeutic efficacy by using pralidoxime chloride continually by syringe pump and increasing the total dosage of pralidoxime chloride in 24 hours in treatment of acute chlorpyrifos poisoning.