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目的评估大剂量氯磷定持续静脉泵入治疗重度有机磷中毒疗效。方法67例患者分为两组:对照组氯磷定首剂重度中毒1.5～2.5,续以每4 h1 g,肌肉注射。治疗组:在30 min内静脉输注负荷剂量氯磷定1.5～2.5 g,在48 h之内每1 h给予氯磷定0.5～1 g,持续静脉输注。随后,即每4小时给予氯磷定1.0 g肌内注射。两组给予相同的清除毒物,应用阿托品。观察两组阿托品量、需要行气管插管辅助通气的比例及时间、7 d胆碱酯酶复常率、反跳率及死亡率判断疗效。结果治疗组7 d胆碱酯酶复常率明显高于对照组(P<0.05);而阿托品量、需要行气管插管辅助通气的比例及时间、反跳率及死亡率则显著低于对照组(P<0.05)。结论大剂量氯磷定持续静脉泵入治疗有机磷中毒能有效提高抢救成功率。
Objective To evaluate the efficacy of continuous intravenous bolus injection of high-dose chlorophosphorus in the treatment of severe organophosphate poisoning. Methods 67 patients were divided into two groups: the control group, the first dose of chlorophosphorus poisoning 1.5 to 2.5, continued every 4 h1 g, intramuscular injection. The treatment group: intravenous infusion of loading dose of chlorophosphonates 1.5 ~ 2.5 g within 30 min, 0.5 ~ 1 g every 1 h within 48 h, continuous intravenous infusion. Subsequently, 1.0 g of chlorophosphonitine was given intramuscularly every 4 hours. The two groups were given the same detoxification, atropine application. Observe the two groups of atropine, the need for endotracheal intubation assisted ventilation ratio and time, 7 d cholinesterase normalization rate, rebound rate and mortality to determine the effect. Results The normalization rate of cholinesterase in the treatment group for 7 days was significantly higher than that in the control group (P <0.05). The percentage and time of atropine intake, tracheal intubation-assisted ventilation, and rebound rate and death rate were significantly lower than those in the control Group (P <0.05). Conclusion Continuous intravenous bolus injection of high-dose chlorophosphorus can effectively improve the success rate of salvage.