血必净注射液联合氯解磷定注射液治疗有机磷农药中毒的临床研究

目的探讨血必净注射液联合氯解磷定注射液治疗有机磷农药中毒的临床疗效。方法选取2012年3月—2016年3月商丘市第一人民医院收治的有机磷农药中毒患者82例,根据治疗方案的不同分为对照组(36例)和治疗组(46例)。对照组足量应用氯解磷定注射液,用药间隔时间为2~4 h,在胆碱酯酶活力≥60%正常值后停药。治疗组在对照组的基础上静脉滴注血必净注射液,50 m L加入生理盐水100 m L,1次/d。两组患者均持续治疗7 d。观察记录两组患者存活情况、中间综合征和胆碱酯酶恢复时间及肌酸激酶同工酶(CK-MB)和肌钙蛋白T(CTn T)变化。结果治疗后,治疗组死亡病例存活时间显著长于对照组,住院时间显著短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组中间综合征发生率和胆碱酯酶恢复正常时间均显著低于对照组,两组比较差异具有统计学意义。治疗后,两组患者CK-MB和CTn T均显著降低,同组比较差异具有统计学意义(P0.05);且治疗组患者CK-MB和CTn T比对照组更低,两组比较差异具有统计学意义(P0.05)。结论血必净注射液联合氯解磷定注射液治疗有机磷农药中毒可降低中间综合征发生率和胆碱酯酶恢复正常时间,具有更好的心肌保护作用,具有一定的临床推广应用价值。

Clinical study on Xuebijing Injection combined with Pralidoxime Chloride Injection in treatment of organophosphorus pesticide poisoning

Objective To evaluate the clinical effect of Xuebijing Injection combined with Pralidoxime Chloride Injection in treatment of organophosphorus pesticide poisoning. Methods Patients (82 cases) with organophosphorus pesticide poisoning in the First People's Hospital of Shangqiu from March 2012 to March 2016 were divided into control (36 cases) and treatment (46 cases) groups according to different treatment. Patients in the control group were iv administered with Pralidoxime Chloride Injection adequately, the time of dosing interval was 2 — 4 h, discontinue medication was administered after ChE ≥ 60% of the normal value. Patients in the treatment group were iv administered with Xuebijing Injection on the basis of the control group, 50 mL added into normal saline 100mL, once daily. Patients in two groups were treated for 7 d. After treatment, survival situation, intermediate syndrome, holinesterase recovery time, CK-MB and CTnT in two groups before and after treatment were compared. Results After treatment, the survival time of death case in the treatment group was significantly longer than that in the control group, also hospital stay was significantly shorter than that in the control group, and there were differences between two groups (P < 0.05). After treatment, the incidence rate of intermediate syndrome and holinesterase recovery time in the treatment group was significantly lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, the CK-MB and CTnT in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). The CK-MB and CTnT in treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xuebijing Injection combined with Pralidoxime Chloride Injection can reduce the incidence of intermediate syndrome and holinesterase recovery time with better myocardial protection, which has a certain clinical application value.