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目的观察机械通气并大剂量氯磷定、参麦针治疗急性有机磷中毒(AOPP)并呼吸肌麻痹(RMP)的临床疗效。方法选择我院2000年3月~2005年3月住院的AOPP并RMP 36例为治疗组,在机械通气的基础上采用氯磷定1~2g持续静脉滴注,6~8h 1次;阿托品针0.5~2mg静脉注射,每30~90m in 1次,维持阿托品化;参麦针100~200m l静滴,每日1次。根据病情调整解毒药用量,共用7~10d。同时选择1997年10月~1999年10月采用常规方法治疗AOPP并RMP 33例患者作为对照,观察两组患者的氯磷定、阿托品、参麦针用量及呼吸机通气时间、重症监护时间、痊愈率。结果治疗组氯磷定、参麦针用量明显偏大,而阿托品用量则明显偏小,与对照组相比,二者差异有显著性(P<0.001),且未见明显不良反应。治疗组与对照组相比,呼吸机通气时间、重症监护时间明显缩短,差异有显著性(P<0.01),痊愈率明显提高,达91.7%(33/36),与对照组相比差异有显著性(P<0.05)。结论机械通气并大剂量氯磷定、参麦针治疗AOPP并RMP有明显疗效。
Objective To observe the clinical efficacy of mechanical ventilation and high-dose chlorpromazine and Shenmai Acupuncture in the treatment of acute organophosphate poisoning (AOPP) and respiratory muscle paralysis (RMP). Methods AOPP and 36 cases of RMP hospitalized in our hospital from March 2000 to March 2005 were selected as the treatment group. On the basis of mechanical ventilation, intravenous infusion of 1 ~ 2g of chlorophosphonazid and continuous intravenous injection of 6 ~ 8h were used. Atropine acupuncture 0.5 ~ 2mg intravenous injection, every 30 ~ 90m in 1, maintaining atropine; Shenmai needle 100 ~ 200m l intravenous infusion, once daily. Adjust the amount of antidote based on the disease, sharing 7 ~ 10d. At the same time, choose the routine treatment of AOPP from October 1997 to October 1999 and 33 cases of RMP as a control, the two groups of patients treated with chlorpromazine, atropine, Shenmai dose and ventilator time, intensive care time, recovery rate. Results In the treatment group, the doses of chlorophosphonates and Shenmai needles were significantly larger, while those of atropine were obviously smaller than those of the control group (P <0.001). No significant adverse reactions were observed. Compared with the control group, the ventilation time of ventilator and intensive care time were significantly shorter in the treatment group and the difference was significant (P <0.01), and the cure rate was significantly improved (91.7%, 33/36) Significance (P <0.05). Conclusion Mechanical ventilation and high doses of chlorpromazine and Shenmai Acupuncture have obvious curative effect on AOPP and RMP.