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目的回顾性分析长托宁(盐酸戊乙奎醚)对比阿托品治疗急性有机磷农药中毒合并心脏损伤患者的疗效。方法收集2003年-2015年急性有机磷中毒合并心脏损伤患者共70例,按入院时间分为A组(2003年1月-2010年12月阿托品联合氯解磷定治疗组)和B组(2011年1月-2015年12月长托宁联合氯解磷定治疗组),比较两组阿托品化(长托宁化)时间、胆碱酯酶回升达50%时间、氯解磷定用量、谵妄的发生率、心脏损伤恢复情况评价。心肌损伤评价指标包括:心肌酶(AST、CK、CK-MB、LDH、cTnI)、QT间期,LVEF(左室射血分数)。结果 B组长托宁品化时间短于A组达阿托品化时间(P<0.05),B组胆碱酯酶活性回升达50%时间短于A组(P<0.05),两组氯解磷定用量及谵妄发生率无统计学意义。两组患者治疗后心肌酶谱水平均明显下降,B组下降更显著,其中CK、CK-MB、cTnI与A组相比有统计学差异性(P<0.05);B组与A组相比,QT间期数值无统计学意义,两组治疗后LVEF前后对比有统计学意义(P<0.05)。结论长托宁救治急性有机磷中毒合并心脏损伤患者的临床疗效优于阿托品,值得临床推广。
Objective To retrospectively analyze the efficacy of penehyclidine hydrochloride (Penehyclidine hydrochloride) versus atropine in patients with acute organophosphorus pesticide poisoning and heart damage. Methods A total of 70 patients with acute organophosphorus poisoning and heart damage from 2003 to 2015 were enrolled in this study. They were divided into group A (atropine combined with chlorpromazine treatment group) and group B (2011 January - December 2010) January 2005 - December 2015 Chang Tuoning combined with chlorpromazine treatment group), compared two groups of atropine (changitonghua) time, cholinesterase recovery of up to 50% of the time, the amount of chlorophenols, delirium The incidence of heart damage recovery assessment. Myocardial damage assessment indicators include: myocardial enzymes (AST, CK, CK-MB, LDH, cTnI), QT interval, LVEF (left ventricular ejection fraction). Results The length of Toning in group B was shorter than that in group A (P <0.05), and the cholinesterase activity in group B was 50% longer than that in group A (P <0.05) The dosage and the incidence of delirium was not statistically significant. CK, CK-MB and cTnI in group B were significantly lower than those in group A (P <0.05); Group B was significantly lower than group A , QT interval was not statistically significant, the two groups after treatment LVEF significant difference (P <0.05). Conclusion The clinical efficacy of Changtuoning in treating patients with acute organophosphate poisoning combined with heart damage is better than atropine, which is worthy of clinical promotion.