Zhu Jia-ying, Chen Cha-hua, Yan Xiao-lian, Xiao Ling, Huang Min
Emergency Department, Jiangxi Province Gaoan City People's Hospital, Gaoan 330800, Jiangxi, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2012 Jun;24(6):346-8.
To investigate the effect of nasal tube feeding of rhubarb solution and umbilical compress of Glauber's salt for purgation in the treatment of patients with severe acute organophosphorus pesticide poisoning (AOPP).
A retrospective study was conducted. Eighty patients with severe AOPP were divided into two groups according to different treatment, with 40 patients in each group. A thorough gastric lavage was done, followed by cholinesterase complex agent and atropine were given for all the patients. On the base of this treatment, one group of patients were given nasogastric feeding of rhubarb solution (200 ml) and Glauber's salt solution ( 100 g) for umbilical compress (rhubarb plus Glauber group),and another group of patients were fed with 20％ mannitol (200 ml)as a control group (mannitol group).The time of first defecation, number of passing stools, the time of normalization of cholinesterase (ChE) activity, time of atropinization, dosage of atropinization, and total amount of atropine given, incidence of adverse reactions, and hospital stay in two groups were observed, a statistical analysis of the data was conducted.
In rhubarb plus Glauber group, all the conditions were improved better than those of mannitol group [first defecation time (minutes):134.13 ± 31.31 vs.154.35 ± 34.78,the number of stools (times/d):2.60 ± 0.81 vs.2.14 ± 0.63,time of ChE activity returned to normal (days):9.65 ± 1.42 vs.10.66 ± 1.74,atropinization time ( hours ):3.00 ± 0.73 vs.3.56 ± 1.02,dosage of atropinization (mg):51.43 ± 7.03 vs. 57.65 ± 7.74,the total amount of atropine given (mg):229.78 ± 28.96 vs. 248.41 ± 31.45, the incidence of adverse reactions: abdominal pain 0 vs. 17.5％,abdominal distention 0 vs. 20.0％,hospital stay (days):10.43 ± 1.68 vs.11.59 ± 2.121,and all the differences were statistically significant (all P＜0.01).
Combination usage with aqueous rhubarb solution and Glauber's salt in AOPP patients could yield quick clearance of toxin, reduced adverse effects, and lower length of hospital stay.
探讨鼻饲大黄溶液联合芒硝脐敷泻下法治疗重度急性有机磷农药中毒（AOPP）患者的效果。
采用回顾性研究。将80例重度AOPP患者按不同治疗方法分为两组，每组40例。所有患者均予彻底洗胃，之后给予胆碱酯酶复能剂和阿托品。在此治疗基础上，一组患者给予鼻饲大黄溶液（200 ml）联合芒硝溶液（100 g）脐敷（大黄加芒硝组），另一组患者给予20％甘露醇（200 ml）鼻饲作为对照组（甘露醇组）。观察两组患者首次排便时间、排便次数、胆碱酯酶（ChE）活性恢复正常时间、阿托品化时间、阿托品化剂量、阿托品总用量、不良反应发生率及住院时间，并对数据进行统计学分析。
大黄加芒硝组各项指标改善情况均优于甘露醇组[首次排便时间（分钟）：134.13±31.31比154.35±34.78，排便次数（次/天）：2.60±0.81比2.14±0.63，ChE活性恢复正常时间（天）：9.65±1.42比10.66±1.74，阿托品化时间（小时）：3.00±0.73比3.56±1.02，阿托品化剂量（mg）：51.43±7.03比57.65±7.74，阿托品总用量（mg）：229.78±28.96比248.41±31.45，不良反应发生率：腹痛0比17.5％，腹胀0比20.0％，住院时间（天）：10.43±1.68比11.59±2.12]，且所有差异均有统计学意义（均P＜0.01）。
重度AOPP患者联合应用大黄溶液和芒硝可快速清除毒素，减少不良反应，缩短住院时间。
