摘要:目的:探讨有机磷农药中毒患者阿托品使用方法,提高抢救成功率。方法: 对2005年6月至2009年6月我院收治的有机磷农药中毒病人281例进行分组,所有患者均使用阿托品疗法,A组为2007年以后132例序贯阿托品疗法患者,B组2007年以前为常规使用静推继之肌注阿托品疗法149例患者,根据有机磷农药对胆碱酯酶复能剂的疗效分为高效组和低效组,并结合病情严重程度共分为重度有机磷农药中毒胆碱酯酶复能剂高效组、重度有机磷农药中毒胆碱酯酶复能剂低效组,轻度有机磷农药中毒胆碱酯酶复能剂高效组、轻度有机磷农药中毒胆碱酯酶复能剂低效组4组,分别从达到阿托品化时间、维持阿托品化效果、反跳和中间综合征发生率、开始撤药平均时间、总住院费用、总住院平均时间、护士劳动强度进行总结和分析。结果: 维持阿托品化疗效Ａ组与B组间有显著差异,P值lt;0.01,开始撤药平均时间、总住院平均时间、总住院费用、护士劳动强度Ａ组与B组间均有差异,P值lt;0.05,发生反跳和中间综合征发生率、达到阿托品化时间在高效组间比较无差异,低效组间比较无差异,高效组与低效组比较有显著差异,P值lt;0.01,主要与中毒药物种类和病情严重程度有关,其次与阿托品治疗方法有关。 结论: 序贯阿托品疗法治疗有机磷农药中毒优于常规使用静推继之肌注阿托品疗法。Abstract: Objective: To discussion of atropine in organophosphorus pesticide poisoning patients with the use of two different methods to improve the success rate. Methods: For June 2005 to June 2009 inour hospital a total of organophosphorus pesticide poisoning 281 cases were divided into A group and B group, All patients were using atropine therapy, 132 cases of sequential therapy in patients with atropine is divided into A group, 149 cases of routine use of intravenous injection and intramuscular injection of atropine group patients were divided into B group, From the following aspects were analyzed and summarized, They are the maintenance of the effect of atropinization, the average time for the beginning of withdrawal, the total hospitalization costs, the total average time for hospitalization and nurses labor intensity. According to the organic phosphorus pesticide on the efficacy of cholinesterase agents are divided into efficient and inefficient groups groups, From the types of poisons, toxic ways, poisoning performance and Complications for stratified, They were divided into 4 groups, severe organophosphorus pesticide poisoning and cholinesterase reactivator can be highly effective group, severe organophosphorus pesticide poisoning and cholinesterase reactivator Lowefficacy group, mild organophosphorus pesticide poisoning and cholinesterase reactivator can be highly effective group, mild organophosphorus pesticide poisoning and cholinesterase reactivator Lowefficacy group, Correlation analysis Antijumping and the incidence of intermediate syndrome and atropinization time.Results:Maintain the efficacy of atropine of A group and B were significantly different between groups, Plt;0.01, the average time began to withdraw drugs, the total average time for hospitalization, total hospital charges, nursing labor intensity of A group and B are differences between the two groups, P＜0.05. Rebound occurs and the incidence of intermediate syndrome, to atropinization time high between the two groups showed no difference between the two groups showed no differences between inefficient and efficient group and inefficient group were significantly different, Plt;0.01, mainly related to poisoning by drug type and severity of illness, followed with atropine therapy. Conclusion:Atropine sequential therapy is superior to organophosphorus pesticide poisoning by conventional atropine treatmen.
ObjectiveTo observe the clinical efficacy of triple aerosol inhalation of pulmicort respules,ipratropine and ventolin in treatment of severe acute asthma exacerbations in adults. Methods46 cases of severe asthmatic patients with acute exacerbations admitted between May 2011 and May 2013 were recruited in the study.They were randomly divided into a treatment group and a control group,23 cases in each group.The control group received aminophylline and methylprednisolone intravenously,while the treatment group received triple aerosol inhalation of pulmicort respules,ipratropine and ventolin on the basic treatment of the control group.The clinical efficacy,the score of asthma symptom of the day and night,the time of disappearance of symptoms and wheezing sound,the glucocorticoid dosage and the incidence of adverse reactions of each group were compared. ResultsComparison of clinical efficacy of two groups drew significant differences (P<0.05) after 7 days.The score of asthma symptom of the day and night in the treatment group was lower than that of the control group (P<0.05).Except cough,the duration of wheezing,breathlessness,chest distress and extinction time of wheezing sound in the treatment group were shorter than those in the control group (P<0.05).The triple inhalation therapy can reduce the dosage and shorten the period of intravenous glucocorticoid treatment with slight adverse reactions (P<0.05). ConclusionIn the treatment of severe asthmatic patients with acute exacerbations,the clinical efficacy of triple aerosol inhalation of pulmicort respules,ipratropine and ventolin on the base of intravenous treatment is satisfactory with rapid onset,which can also reduce the glucocorticoid dosage and the incidence of adverse reactions.So the combination therapy is worthy of clinical use.