Yu Li-qin, Zheng Xue-qin
Emergency Center, Wuwei City People's Hospital, Wuwei 733000, Gansu, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2012 Jun;24(6):349-51.
To investigate the clinical efficacy of penehyclidine hydrochloride sequential to atropine in severe acute organophosphorus pesticide poisoning (AOPP).
A retrospective analysis of the clinical data of 180 patients with severe AOPP admitted to the Emergency Center of Wuwei City People's Hospital from January 2007 to August 2011 was conducted. The patients were divided into penehyclidine hydrochloride sequential to atropine group, atropine group and penehyclidine hydrochloride group according to difference of anti-choline drugs using, with 60 cases in each group. The complication rate, time of recovery of cholinesterase (ChE) activity to 70％, hospital stay time and cost, the cure rate, mortality rate in three groups were analyzed.
In penehyclidine hydrochloride sequential to atropine group, except for 1 case of cancer of gastric cardia with poisoning after operation showing intermediate syndrome of poisoning, the remaining patients did not have any complication, and the incidence of complications was 1.67％.No death occurred in all the patients, and the cure rate was 100.00％.Time of recovery from ChE activity to 70％ was (4.0 ± 1.1 ) days; hospital stay was (7.0 + 2.2) days; hospital expenses were (6268 ± 238 ) yuan. In atropine group, 3 patients were found to have atropine resistance, 3 patients showed intermediate syndrome, rebound was observed in 2 cases, atropine poisoning in 2 patients, and the incidence of complications was 16.67％.Three patients died of respiratory or circulatory failure, and the mortality rate was 5.00％.Fifty-seven patients were cured, the cure rate was 95.00％.The time of ChE activity recovery to 70％ was (8.0 ± 0.9) days. Hospital stay was (12.0 ± 2.1) days. Hospital expenses were (7160 ± 110) yuan. In penehyclidine hydrochloride group, 1 patient was found to have respiratory failure, 1 case suffered from pulmonary edema, and the complication rate was 3.33％.Two patients died, the mortality rate wan 3.33％.Fifty-eight patients were cured, the cure rate was 96.67％.The time of ChE activity recovery to 70％ was (6.0 ± 0.7) days, hospital stay was (9.0 ± 1.5) days, and hospital expenses were (7921 ± 230) yuan. Compared with atropine group, penehyclidine hydrochloride sequential to atropine group had a low death rate, high cure rate, less complications, ChE activity recover fast, short hospital days, and the hospitalization expenses were lower than that of the single use of atropine or single use of penehyclidine hydrochloride group, and the differences were statistically significant (all P＜0.01).
In treatment of severe AOPP by penehyclidine hydrochloride sequential to atropine, curative effect was more significant, with fewer adverse reactions, short hospital stay, and lower cost.
探讨盐酸戊乙奎醚序贯阿托品治疗重度急性有机磷农药中毒（AOPP）的临床疗效。
回顾性分析2007年1月至2011年8月收治于武威市人民医院急救中心的180例重度AOPP患者的临床资料。根据抗胆碱药物使用差异将患者分为盐酸戊乙奎醚序贯阿托品组、阿托品组和盐酸戊乙奎醚组，每组60例。分析三组的并发症发生率、胆碱酯酶（ChE）活性恢复至70％的时间、住院时间及费用、治愈率、死亡率。
盐酸戊乙奎醚序贯阿托品组，除1例贲门癌术后中毒患者出现中毒中间综合征外，其余患者均未出现任何并发症，并发症发生率为1.67％。所有患者均无死亡，治愈率为100.00％。ChE活性恢复至70％的时间为（4.0±1.1）天；住院时间为（7.0 + 2.2）天；住院费用为（6268±238）元。阿托品组，3例患者出现阿托品耐药，3例出现中间综合征，2例出现反跳，2例出现阿托品中毒，并发症发生率为16.67％。3例患者死于呼吸或循环衰竭，死亡率为5.00％。57例患者治愈，治愈率为95.00％。ChE活性恢复至70％的时间为（8.0±0.9）天。住院时间为（12.0±2.1）天。住院费用为（7160±110）元。盐酸戊乙奎醚组，1例患者出现呼吸衰竭，1例出现肺水肿，并发症发生率为3.33％。2例患者死亡，死亡率为3.33％。58例患者治愈，治愈率为96.67％。ChE活性恢复至70％的时间为（6.0±0.7）天，住院时间为（9.0±1.5）天，住院费用为（7921±230）元。与阿托品组比较，盐酸戊乙奎醚序贯阿托品组死亡率低、治愈率高、并发症少、ChE活性恢复快、住院天数短，且住院费用低于单用阿托品或单用盐酸戊乙奎醚组，差异均有统计学意义（均P＜0.01）。
盐酸戊乙奎醚序贯阿托品治疗重度AOPP疗效更显著，不良反应少，住院时间短，费用低。
