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[摘要]
目的 探讨醒脑静注射液联合氯解磷定治疗有机磷中毒的临床疗效。方法 选取2013年1月—2017年1月在上海交通大学附属第六人民医院进行抢救的有机磷中毒患者80例,根据药物的差别分为对照组(40例)和治疗组(40例)。对照组肌肉注射氯解磷定注射液,1 g/次,1次/1 h,治疗3次后,改为1次/2 h,治疗6 h后为1 g/4 h,24 h后1 g/8 h,维持至72 h,24 h总量≤ 10 g。治疗组在对照组基础上静脉滴注醒脑静注射液,20 mL加入250 mL生理盐水,1次/d。两组均治疗3 d。观察两组患者临床疗效,比较治疗前后两组患者昏迷复醒时间、机械通气时间、胆碱酯酶(ChE)活性恢复时间和住院时间以及运动神经传导速度(MCV)和感觉神经传导速度(SCV)。结果 治疗后,对照组和治疗组临床有效率分别为77.50%和95.00%,两组比较差异具有统计学意义(P < 0.05)。治疗后,治疗组患者昏迷复醒时间、机械通气时间、ChE活性恢复正常时间和住院时间均明显短于对照组,两组比较差异具有统计学意义(P < 0.05)。治疗后,治疗组正中神经、尺神经和腓肠神经中MCV和SCV均显著快于对照组,两组比较差异具有统计学意义(P < 0.05)。结论 醒脑静注射液联合氯解磷定治疗有机磷中毒效果显著,可有效促进患者康复,具有一定的临床推广应用价值。
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[Abstract]
Objective To evaluate the clinical efficacy of Xingnaojing Injection combined with pralidoxime chloride in treatment of organophosphate poisoning. Methods Patients (80 cases) with organophosphate poisoning in the Sixth People's Hospital Affiliated to Shanghai Jiaotong University from January 2013 to January 2017 were divided into control (40 cases) and treatment (40 cases) groups based on different treatments. Patients in the control group were intramuscular injection administered with Pyraloxime Methylchloride, 1 g/time, once 1 h, then once 2 h after 3 h, then once 4 h after 6 h, and once 8 h after 24 h, and maintained for 72 h, the total dose of 24 h ≤ 10 g. Patients in the treatment group were iv administered with Xingnaojing Injection on the basis of the control group, 20 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 3 d. After treatment, the clinical efficacy was evaluated, the time of coma reawakening, mechanical ventilation, ChE activity recovery and hospitalization, and the MCV and SCV in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 77.50% and 95.00%, respectively, and there were differences between two groups (P < 0.05). After treatment, the time of coma reawakening, mechanical ventilation, ChE activity recovery and hospitalization in the treatment group was significantly shorter than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the MCV and SCV of median nerve, ulnar nerve, and gastrocnemius nerve in the treatment group were significantly faster than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xingnaojing Injection combined with pralidoxime chloride has significant effect in treatment of organophosphate poisoning, and can effectively promote the rehabilitation of patients, which has a certain clinical application value.
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