小剂量阿托品治疗急性重度有机磷中毒207例临床疗效分析_临床医学论文.docVIP

小剂量阿托品治疗急性重度有机磷中毒207例临床疗效分析_临床医学论文 小剂量阿托品治疗急性重度有机磷中毒207例临床疗效分析_临床医学论文 【摘要】 目的 探讨应用小剂量阿托品治疗急性有机磷农药中毒的临床疗效。方法 该研究对我院2006年3月至2010年2月确诊的急性重度有机磷农药中毒患者病历资料进行回顾性分析,对照组为进行常规治疗的确诊患者,治疗组为应用小剂量阿托品进行治疗的确诊患者。对二组患者治疗结果进行临床分析。二组间均数比较采用方差分析。计数资料采用四格表χ2检验。结果 该研究入选患者207例,二组患者年龄、性别及服药剂量分布差异无统计学意义(Pgt;0.05)。治疗组存活率较对照组明显提高,住院时间明显缩短,发生呼吸衰竭等并发症较对照组明显减少。结论 小剂量阿托品治疗急性重度有机磷农药中毒疗效明显优于传统剂量阿托品治疗。 　　【关键词】有机磷农药中毒;小剂量;阿托品;临床疗效 　　【Abstract】 Objective To investigate the effect of atropine in the treatment of acute organophosphorus pesticide poisoning.Methods The data of severe acute organophosphorus pesticide poisoning cases from March 2006 to February 2010 in our Emergency Department were retrospective reviewed. The cases were divided into treatment group and control groups.Control group included cases that received conventional therapy,treatment group included cases that received therapy with low dose atropine.Mean of two groups were analyzed by using ANOVA,and the rate were compared with chi-square test.Statistical significance was established at a P value of less than 0.05.Results 207 cases were included in our study.There was no significant difference in age,genders and poisoning dose between the two groups(Pgt;0.05).The survival rate in the treatment group was higher than that in control group.The length of stay was shorter,and the complications such as respiratory failure was fewer.Conclusion Low dose atropine is better than conventional dose atropine in treatment of severe acute organophosphorus pesticide poisoning. 　　【Key words】 　　Acute organophosphorus pesticide poisoning; Low dose; Atropine; Therapeutic effect 　　 　　急性有机磷农药中毒(acute organophosphorus insecticide poisoning,AOIP)是内科急危病症之一,在基层医院中占内科急诊中毒的首位。阿托品因其具有与乙酰胆碱争夺胆碱受体,起到阻断乙酰胆碱的作用,故做为急性有机磷中毒的特效解毒剂在临床被广泛应用。但阿托品临床最低致死量仅为80~130 mg[1],其用药浓度、剂量、给药间隔时间、给药方式及阿托品化的正确观察等直接关系到患者的抢救治疗效果,治疗应用不当常导致严重后果。我院自2008年3月始应用小剂量阿托品治疗AOIP患者取得显著疗效,现综合临床资料进行回顾性对比分析,旨在探讨抢救重度AOIP患者阿托品应用剂量对患者预后的影响。 　　1 资料与方法 　　1.1 研究对象 回顾分析2006年3月至2010年2月因有机磷农药中毒来我院急诊住院(部分患者由