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目的 :观察丙种球蛋白辅助治疗急性有机磷杀虫药中毒致外周呼吸肌麻痹的临床效果。方法 :116例急性有机磷杀虫药中毒致呼吸肌麻痹患者随机分为实验组和对照组各 5 8例 ,两组患者基础治疗相同 ,试验组在此基础上加用丙种球蛋白 10 g/d静脉滴注 ,疗程 3日 ;比较两组疗效。 结果 :试验组痊愈率为 98% ,对照组痊愈率为 87% ,两组比较无统计学意义 (P >0 0 5 )。全血胆碱酯酶活力 :试验组治疗前后分别为 0 2 5± 0 0 9、 0 5 4± 0 12 ,对照组为 0 2 4± 0 0 9、 0 4 9± 0 12 ;两组治疗后胆碱酯酶水平均有所提高 (均为P <0 0 1) ,但两组的差异无统计学意义 (P >0 0 5 )。试验组的机械通气时间和住院时间较对照组缩短 (P <0 0 5和P <0 0 1) ,并发呼吸机相关肺炎发生率低于对照组 (17%比 5 9% ,P<0 0 1) ;且未发现严重不良反应。结论 :丙种球蛋白对急性有机磷杀虫药中毒致呼吸肌麻痹有治疗价值。
Objective: To observe the clinical effect of gamma globulin adjuvant treatment of peripheral respiratory muscle paralysis caused by acute organophosphate insecticide poisoning. Methods: One hundred and sixteen patients with respiratory muscle paralysis caused by acute organophosphate insecticide poisoning were randomly divided into experimental group and control group (58 cases each). The basic treatment was the same in both groups. On the basis of this, the experimental group added gamma globulin 10 g / d intravenous drip, treatment on the 3rd; compare the two groups curative effect. Results: The cure rate of the experimental group was 98%, while that of the control group was 87%. There was no significant difference between the two groups (P> 0.05). Whole blood cholinesterase activity: the experimental group before and after treatment were 0 2 5 ± 0 0 9, 0 5 4 ± 0 12, the control group was 0 2 4 ± 0 0 9, 0 4 9 ± 0 12; two groups of treatment After cholinesterase levels were increased (all P <0.01), but the difference between the two groups was not statistically significant (P> 0.05). The experimental group had shorter duration of mechanical ventilation and hospital stay than the control group (P <0.05 and P <0.01), and the incidence of ventilator-associated pneumonia was lower in the experimental group than in the control group (17% vs. 59%, P <0 0 1); and found no serious adverse reactions. Conclusion: Gamma globulin has therapeutic value on respiratory muscle paralysis caused by acute organophosphate pesticide poisoning.