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目的探讨负荷量后持续静脉滴注氯解磷定治疗急性有机磷农药中毒的临床疗效。方法将62例中、重度急性有机磷农药中毒患者随机分成负荷量后持续静脉注射氯解磷定治疗组(观察组)与间歇静脉滴注氯解磷定治疗组(对照组),每组31例,比较两组间阿托品和氯解磷定用量、阿托品化时间、血浆胆碱酯酶活性(CHE)恢复时间、不良反应发生情况、平均住院时间及CHE水平的动态变化等指标。结果观察组患者救治过程中氯解磷定总用量大于对照组,差异有统计学意义(P<0.01),阿托品总用量、阿托品化时间、CHE恢复时间、不良反应发生率及平均住院时间均小于对照组,差异有统计学意义(P<0.01,P<0.05,P<0.01,P<0.01,P<0.05)。入院即刻及治疗12h时,两组间CHE比较差异均无统计学意义(均P>005);入院治疗24h、48h及72h时,观察组CHE均明显优于对照组,差异有统计学意义(均P<0.05)。结论负荷量后持续静脉注射氯解磷定救治AOPP可迅速恢复血浆胆碱酯酶活性,其临床效果明显优于分次静脉滴注氯解磷定法。
Objective To investigate the clinical efficacy of sustained intravenous infusion of chlorpheniramine in the treatment of acute organophosphorus pesticide poisoning after loading. Methods Sixty-two patients with moderate to severe acute organophosphorus pesticide poisoning were randomly divided into three groups: continuous intravenous injection of chlorpheniramine (the observation group) and intermittent intravenous chlorpheniramine treatment group (control group), with 31 Cases were compared between the two groups atropine and chlorophenol dose, atropine time, plasma cholinesterase activity (CHE) recovery time, adverse reactions, the average length of stay and changes in CHE levels and other indicators. Results The total amount of chlorophenanthroline in the observation group was significantly higher than that of the control group (P <0.01). The total amount of atropine, atropisol time, recovery time of CHE, incidence of adverse reactions and average length of stay were all less than Control group, the difference was statistically significant (P <0.01, P <0.05, P <0.01, P <0.01, P <0.05). There was no significant difference in CHE between the two groups immediately after admission and 12h treatment (all P> 005). CHE in observation group was significantly better than that in control group at 24h, 48h and 72h after admission All P <0.05). CONCLUSION: Continuous intravenous injection of chlorophyll-phospholipid AOPP after loading can rapidly restore the activity of plasma cholinesterase, and its clinical effect is obviously superior to that of intravenous chlorophyll-fixing assay.