呼吸机联合阿托品与氯解磷定治疗重度有机磷农药中毒的临床研究

目的观察呼吸机联合不同剂量阿托品和氯解磷定治疗濒死重度有机磷农药中毒的临床效果。方法117例濒死重度有机磷农药中毒患者，根据是否用使用呼吸机分为呼吸机联合阿托品氯解磷定组（治疗组），仅使用阿托品氯解磷定、未用呼吸机组（对照组）。治疗组根据人院后最大阿托品用量分为两亚组，适量组：最大用量≤100mg／h；大剂量组：最大用量〉100mg／h。结果治疗组痊愈率高于对照组，差异有统计学意义（P〈0．01）。两亚组比较，适量组死亡率和阿托品中毒率低于大剂量组，阿托品总用量少于大剂量组（P〈0．01）。两亚组间机械通气时间、ICU住院时间、总住院时间差异无统计学意义（P〉0．05）。结论抢救濒死重度有机磷农药中毒，应在阿托品联合复能剂的基础上应用机械通气，机械通气要及时，阿托品应该足量、个体化使用，尽量避免大剂量应用，用药过程中严密观察患者的反应。

Clinical research of respirator combined with atropine and pralidoxime chloride treating severe organophosphorus pesticide poisoning

Objective To observe the clinical effect of respirator combined with atropine and pralidoxime chloride treating severe organophosphorus pesticide poisoning. Methods 117 cases of patients with severe organophosphorus pesticide poisoning were selected and divided into two groups,the treatment group （respirator combined with atropine and pralidoxime chloride group） and the control group （only using atropine and pralidoxime chloride without using respirator group）.And according to the maximal dosage of atropine,the treatment group was divided into two subgroups.For the appropriate amount group,the maximal usage was less than or equal to 100 mg/h,and for the large dosage group,the maximal usage was greater than 100 mg/h. Results The recovery rate of the treatment group and control group had significant difference （P〈0.01）.For two subgroups,the death rate and poisoning rate of atropine in the appropriate amount group was lower than that of the large dosage group,and the total dosage of atropine was less than that of the large dosage group （P〈0.01）.There was no difference for the duration of ventilatory support,ICU length of stay and the total length of stay between two subgroups （P〉0.05）. Conclusion Rescuing the patients with severe organophosphorus pesticide poisoning should use mechanical ventilation based on atropine combined with pralidoxime chloride.Mechanical ventilation should be timely.And there is enough atropine,and it is used individually.And large-dosage application should be avoided.The reaction of patients should be observed in the medication process.