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目的观察碳酸氢钠联合血必净注射液辅助治疗急性重度敌敌畏中毒的疗效。方法将符合研究条件的105例急性重度敌敌畏中毒患者,随机分为常规治疗组(n=52)和实验观察组(n=53)。常规治疗组给予清水彻底洗胃,实验观察组采用2.5%碳酸氢钠溶液洗胃。两组均给予导泻、吸氧、补液、利尿、解毒药物阿托品和氯磷定等治疗措施。实验观察组在综合治疗的基础上,加用5%碳酸氢钠注射液联合血必净注射液治疗,对比两组患者的临床治疗效果。结果实验观察组从第3天开始,胆碱酯酶活性高于常规治疗组,差异有统计学意义(P<0.05);达到阿托品化时间、阿托品总用量、氯磷定总用量、入住重症监护室时间及机械通气(>72 h)例数比例、血清hs CRP浓度、APACHEⅡ评分均低于常规治疗组,差异有统计学意义(P<0.05);两组患者的动脉血p H值、HCO_3~-浓度差异无统计学意义(P>0.05)。结论碳酸氢钠联合血必净注射液治疗急性重度敌敌畏中毒,可提高治疗效果,对胆碱酯酶活性的恢复呈现有益影响。
Objective To observe the curative effect of sodium bicarbonate combined with Xuebijing Injection in the treatment of acute severe dichlorvos poisoning. Methods A total of 105 acute severe dichlorvos poisoning patients were randomly divided into routine treatment group (n = 52) and experimental observation group (n = 53). Routine treatment group was given clean water thoroughly gastric lavage, experimental observation group gastric lavage with 2.5% sodium bicarbonate solution. Both groups were given catharsis, oxygen, rehydration, diuretic, detoxification drugs atropine and chlorpromazine treatment measures. The experimental group was treated with 5% sodium bicarbonate injection combined with Xuebijing injection on the basis of comprehensive treatment, and the clinical treatment effect was compared between the two groups. Results The experimental group had higher cholinesterase activity than the conventional treatment group on the third day (P <0.05), the time of atropine administration, the total amount of atropine, the total dosage of chlorophosphonates, (P> 0.05). There was no significant difference between the two groups in arterial blood p H value, HCO 3 (P <0.05) ~ - concentration difference was not statistically significant (P> 0.05). Conclusion Sodium bicarbonate combined with Xuebijing Injection in the treatment of acute severe dichlorvos poisoning can improve the therapeutic effect and exert a beneficial effect on the recovery of cholinesterase activity.