长效托宁与解磷定联合治疗急性有机磷农药中毒的临床研究

目的探讨长效托宁与解磷定联合治疗急性有机磷杀虫药中毒（acute organophosphorous insecticides poisoning，AOPP）的临床疗效。方法根据随机数字法将102例急性有机磷农药中毒患者随机分为对照组和观察组，其中观察组采用长效托宁与解磷定联合治疗，对照组采用阿托品治疗，比较研究两组的临床疗效及不良反应。结果51例观察组患者的M样症状消失时间、胆碱酯酶活力恢复时间、用药次数、住院时间等临床指标与对照组相比均有明显差异；观察组的治愈率较对照组明显提高，而死亡率则明显下降，差异有统计学意义（P均〈0．05）.两组患者在治疗过程中均存在不同程度的口干、心跳加快、面红、瞳孔扩大、少数有谵语、烦躁不安、尿潴留等不良反应；除了上述症状外，对照组中有2例患者发生中间综合征，3例患者发生阿托品中毒。结论长效托宁治疗急性中重度有机磷农药中毒疗效可靠，抗中枢神经系统中毒症状的作用强，不良反应小，临床工作人员易于掌握剂量，值得临床推广使用。

Melatonin and Pralidoxime Long-term Treatment of Acute Organophosphorus Pesticide Poisoning Clinical Study

Objective To evaluate the long-term Melatonin and pralidoxime treatment of acute organophosphorus pesticide poisoning （ Acute organophosphorous insecticides poisoning, AOPP ） in the clinical efficacy. Methods In accordance with the method 102 patients were randomly acute organophosphorus pesticide poisoning were randomly divided into control group and observation group, in which long-term observation group were treated with pralidoxime hydrochioride combination therapy, the control group treated with atropine, comparative study two groups of clinical efficacy and adverse reactions. Results 51 cases observed in the M group were time-like symptoms, cholinesterase recovery times, medication times, the clinical indicators of hospital stay compared with the control group were significantly different; In addition, the observation group than the control group cure rate significantly improved, and the mortality decreased significantly, and the difference was statistically significant （ P all 〈 0.05 ）. Two groups of patients during treatment are varying degrees of dry mouth, rapid heartbeat, flushing, pupil dilation, a small number of delirium, irritability, urinary retention and other adverse reactions ; addition to the above symptoms, the control group occurred in 2 patients Intermediate syndrome, 3 patients developed atropine poisoning. Conclusion The long-acting hydrochloride in the treatment of acute severe organophosphorus pesticide poisoning reliable efficacy against the role of the central nervous system symptoms strong side effects, care less, easy to grasp dose clinical staff, worthy of clinical use.