Yan Yong-Jian, Li Xiu-Ju, Ning Guo-Ying, Zhao Xue-Bin, Pan Yong-Feng, Yan Xiao-Yong, Li Zhi-Hong, Zhang Xiu-Wei, Sun Ming-Xia, Li Li
Shandong Academy of Labour Hygiene and Occupational Disease, Jinan 250002, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2010 May;28(5):321-4.
To explore the norms of treatment of acute organophosphorus pesticide poisoning (AOPP), and observe the curative effect.
On basis of the pre-research, the norms of treatment of AOPP were summarized, and a multi-center clinical trial was performed in 6 hospitals selected from high incidence of AOPP in Shandong Province.
422 patients of AOPP in 6 hospitals in observation period were treated and observed by the norms of treatment. Among them, the proportion of oral poisoning was 97.16%, middle and severe degree were 87.44%. Compared with themselves 2 years ago before standard treatment, the curative effect of the norms of treatment for AOPP was much better than before. The mortality rate of AOPP declined from 9.87% to 1.66% (Chi2 = 27.92, P < 0.01), that was much better than the average therapeutic effect level of all our province in the same period (the mortality rate: 8.92%) (Chi2 = 26.05, P < 0.01). The average amount of atropine [(37.54 +/- 17.76) mg], dropped greatly [(1280.70 +/- 69.22) mg] (U = 439.22, P < 0.01).The usage of atropine by continuous intravenous injection with venous pump was better than ordinary intravenous injection. The mean dosage of pralidoxime chloride increased twice than the previous (U = 19.48, P < 0.01). There was no drug poisoning.
The standard treatment of AOPP is urgently needed in our country, especially in rural area. By this trial, the satisfactory effect of the norms of treatment for AOPP summarized is observed and it reduces the fatality rate remarkably.
探讨急性有机磷农药中毒(AOPP)的治疗规范,并观察其疗效。
在前期研究的基础上,总结AOPP的治疗规范,并在山东省AOPP高发地区选取的6家医院进行多中心临床试验。
6家医院观察期内的422例AOPP患者按照治疗规范进行治疗和观察。其中,口服中毒比例为97.16%,中重度为87.44%。与标准治疗前2年相比,AOPP治疗规范的疗效明显优于以前。AOPP死亡率从9.87%降至1.66%(χ2 = 27.92,P < 0.01),明显优于同期全省平均治疗效果水平(死亡率:8.92%)(χ2 = 26.05,P < 0.01)。阿托品平均用量[(37.54±17.76)mg]大幅下降[(1280.70±69.22)mg](U = 439.22,P < 0.01)。静脉泵持续静脉注射阿托品的使用效果优于普通静脉注射。氯解磷定平均用量比以前增加了两倍(U = 19.48,P < 0.01)。无药物中毒发生。
我国尤其是农村地区迫切需要AOPP的规范治疗。通过本试验,观察到总结的AOPP治疗规范取得了满意效果,显著降低了病死率。