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[碳酸氢钠联合乌司他丁对急性辛硫磷农药中毒患者胆碱酯酶活性的影响]

[The influence of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning].

作者信息

Zhao Bo, Yang Lanju, Xiao Lei, Sun Baoquan, Zou Xianbao, Gao Dongmei, Jian Xiandong

机构信息

Liaocheng People's Hospital, Sandong Province Liaocheng 252000, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2016 Jan;34(1):53-5. doi: 10.3760/cma.j.issn.1001-9391.2016.01.015.

Abstract

OBJECTIVE

To observe the effect of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning.

METHODS

A total of 67 eligible patients with acute phoxim pesticide poisoning, Who were admitted to the emeryency department of hospital from March 2011 to February 2014, Acording to different treatments au patients were randomly divided into the conventional treatment group (n=34) and the sodium bicarbonate+ulinastatin group (n=35) . The conventional treatment group were given thorough gastric lavage with water, the sodium bicarbonate + ulinastatin group were given gastric lavage with 2% sodium bicarbonate solution. Both groups were given such treatments as catharsis, administration of oxygen, fluid infusion, diuresis, and antidotes such as atropine and pralidoxime methylchloride. On the basis of comprehensive treatment, people in the sodium bicarbonate+ulinastatin group were given 5% sodium bicarbonate injection and ulinastatin. The clinical effect of the two groups were compared.

RESULTS

The serum cholinesterase activity of the sodium bicarbonate+ulinastatin group was significantly higher than the conventional treatment group from the 5th day, and the difference was statistically significant (P<0.05) . The total atropine dosage, total pralidoxime methylchloride dosage and hospitalization days were better than the conventional treatment group, and the differences were statistically significant (P<0.05) . The difference in the time of atropinization between the two groups was not statistically significant (P>0.05) . The results of arterial blood pH, HCO3- of the sodium bicarbonate + ulinastatin group were higher than the conventional treatment group, and the difference of HCO3- at the 10th day was statistically significant (P<0.05) .

CONCLUSIONS

Sodium bicarbonate combined with ulinastatin can improve the therapeutic effect and reduce complications in the treatment of acute phoxim pesticide poisoning, and have beneficial effects on the recovery of cholinesterase activity.

摘要

目的

观察碳酸氢钠联合乌司他丁对急性辛硫磷农药中毒患者胆碱酯酶活性的影响。

方法

选取2011年3月至2014年2月在我院急诊科住院的67例符合条件的急性辛硫磷农药中毒患者,根据不同治疗方法将所有患者随机分为常规治疗组(n = 34)和碳酸氢钠 + 乌司他丁组(n = 35)。常规治疗组用清水彻底洗胃,碳酸氢钠 + 乌司他丁组用2%碳酸氢钠溶液洗胃。两组均给予导泻、吸氧、补液、利尿及应用阿托品、氯解磷定等解毒剂治疗。在综合治疗的基础上,碳酸氢钠 + 乌司他丁组给予5%碳酸氢钠注射液及乌司他丁。比较两组的临床疗效。

结果

碳酸氢钠 + 乌司他丁组血清胆碱酯酶活性自第5天起显著高于常规治疗组,差异有统计学意义(P < 0.05)。阿托品总用量、氯解磷定总用量及住院天数均优于常规治疗组,差异有统计学意义(P < 0.05)。两组阿托品化时间差异无统计学意义(P > 0.05)。碳酸氢钠 + 乌司他丁组动脉血pH、HCO₃⁻结果高于常规治疗组,第10天HCO₃⁻差异有统计学意义(P < 0.05)。

结论

碳酸氢钠联合乌司他丁治疗急性辛硫磷农药中毒可提高治疗效果,减少并发症,对胆碱酯酶活性的恢复有有益作用。

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