盐酸戊乙奎醚联合阿托品与单纯使用阿托品治疗重度急性有机磷中毒的临床疗效对比

目的：评价盐酸戊乙奎醚联合阿托品与单纯使用阿托品治疗重度急性有机磷中毒的临床疗效，探讨其临床适用性。方法病例选择从2013年5月至2014年4月于我院就诊的74例重度急性有机磷中毒患者。简单随机分为试验组37例和对照组37例，对照组患者给予单纯阿托品救治，试验组患者给予戊乙奎醚联合阿托品治疗。观察两组患者的阿托品总使用量，临床治愈疗效情况，观察两组患者胆碱酯酶活力恢复时间、中毒症状消失时间、平均住院时间和不良反应发生情况。结果试验组患者的阿托品总使用量为9．44±5．12mg，对照组患者阿托品总使用量为29．83±6．27mg，差异有统计学意义（t＝15．322，P＝0．000）；试验组患者治愈率为97．30％（36／37），对照组患者治愈率为94．59％（35／37），差异无统计学意义（χ2＝0．35，P＝0．5556）。试验组胆碱酯酶活力恢复时间、中毒症状消失时间和平均住院时间均明显低于对照组患者（ P ＜0．05）；试验组患者的相关不良反应发生比率低于对照组患者（P＜0．05）。结论盐酸戊乙奎醚联合阿托品治疗重度急性有机磷中毒患者的临床疗效显著，通过降低阿托品的使用剂量，也减少不良反应的发生，适合临床长期推广应用。

The Comparison of the CIinicaI Efficacy of the Treatment of Atropine Joint PenehycIidine HydrochIoride and Atropine aIone on Severe Acute Organo-phosphorus Poisoning

OBJECTIVE To analyze the the clinical efficacy of the treatment of Penehyclidine hydrochloride andatropineonsevereacuteorganophosphoruspoisoning,andtoexploreitsclinicalapplication.METHODS 74 cases of severe acute organic phosphorus poisoning patients were selected from May 2013 to April 2014 in our hospi-tal,and they were simplely and randomly divided into the experimental group (37 cases) and the control group (37 cases).The control group were treated with atropine treatment,while the experimental group was given the treatment of the combination of penehyclidine hydrochloride and atropine.Then observed the total amount of atropine in the two groups,and the clinical curative effect,and the recovery time of the AChE activity,the symptoms disappeared,the av-erage length of hospital stay and adverse reactions of the two groups was also observed.RESULTS The total dosage of atropine in the experimental group was 9.44 ±5.12mg,while the total dosage of atropine in the control group was 29.83 ±6.27mg,and the difference was statistically significant (t=15.322,P=0.000);The cure rate was 97.30%(36/37) in the experimental group,and was 94.59%(35/37) in the control group,the difference was not statistical-ly significant (χ2 =0.35,P=0.5556).The recovery time of AChE activity,the disappearance time of symptoms and the average length of hospital stay were significantly lower than those in the control group ( P<0.05).The incidence of adverse reactions in the experimental group was significantly lower than that in the control group ( P <0.05 ) .CONCLUSION The clinical efficacy of the treatment of severe acute organic phosphorus poisoning patients with the combination of hydrochloric acid hydrochloride and atropine is significant,and it can also reduce the incidence of adverse reactions by lowering the dosage of atropine.