氯磷定治疗急性有机磷中毒中间期肌无力综合征

目的:比较不同剂量氯磷定方案对急性有机磷农药中毒(AOPP)致中间期肌无力综合征(IMS)的治疗效果。方法:对56例AOPP致IMS患者进行回顾性分析,据氯磷定用量分为大剂量氯磷定组(Ⅰ组n=29)和非大剂量组(Ⅱ组n=27),观察2组病例间的治愈率、病死率、自主呼吸恢复时间和住院时间。结果:Ⅰ组患者治愈率明显高于Ⅱ组(Ⅰ组93.1%,Ⅱ组66.7%),P<0.05;自主呼吸恢复平均时间明显快于Ⅱ组(Ⅰ组,28.6 h±11.3 h;Ⅱ组,52.8 h±14.6 h),P<0.001,病死率明显低于Ⅱ组(Ⅰ组6.9%,Ⅱ组33.3%),P<0.05;Ⅰ组患者住院时间比Ⅱ组明显缩短(Ⅰ组15.8 d±4.6 d,Ⅱ组19.8 d±6.6 d),P<0.01。结论:早期应用大剂量氯磷定治疗对AOPP致IMS患者自主呼吸的恢复有较好疗效、能够明显缩短住院时间、提高临床治愈率。

Clinical observation for the effects of pralidoxime chloride on intermediate myasthenia syndrome following acute organophosphorus pesticide poisoning

Objective: To compare the effects of pralidoxime chloride between big-dose and no-big-dose on intermediate myasthenia syndrome(IMS) following acute organophosphorus pesticide poisoning(AOPP).Methods: 56 cases of IMS due to AOPP were analyzed retrospectively and were divided into two groups by the dose of pralidoxine chloride: Group I(n=29) they were given pralidoxime chloride 9.5-16.0 grams(with an average of 10.4 2.0 grams) everyday in the first three days after onset.Group II(n=27) patients;the dose of pralidoxime chloride was used daily in the first three days ranged from 4.5-8.0 grams(average 5.5±3.5 g).In both groups,the curative rates,the mortality,the time of spontaneous breath recovery and the average days in hospital were observed.Results: The curative rate in Group I were significantly higher than that in Group II(93.1% VS 66.7%,P<0.05) and the death rate in Group I were significantly lower than that in Group II(6.9% VS 33.3% P<0.05).The average days in hosputals in Group I were also significantly shorter than that in Group II(15.8±4.6 d VS 19.8±6.6 d P<0.01).Conclusion: Large dose pralidoxime chloride used early has more effects on large dose for patients with IMS due to AOPP and this kind of administration can remarkablly shorted the average days in hospital and improve the prognosis in such patients.