黄天桥

摘要：目的  对应用阿托品治疗有机磷中毒中间断静脉注射和静脉泵入的效果进行探讨。方法  选择我院2017年1月至2018年10月收治的有机磷中毒患者100例，依据随机数字表法分为实验组（n=50）和常规组（n=50）。常规组接受间断静脉注射阿托品治疗，实验组接受持续静脉泵入阿托品治疗，统计并对比两组治疗效果。结果  实验组症状缓解时间、阿托品化时间均显著低于常规组（P<0.05）。两组治愈率对比差异无统计学意义（P>0.05）。实验组反跳、过量、后遗症发生率均显著低于常规组（P<0.05）。结论  针对有机磷中毒患者应用阿托品持续静脉泵入治疗可提升疗效，并且见效更快，安全性较高，值得进行广泛推广。

关键词：持续静脉泵入;间断静脉注射;阿托品;有机磷中毒

【中图分类号】R734    【文献标识码】A    【文章編号】2107-2306（2019）01-010-02

[abstract] objective： to investigate the effect of atropine on intermittent intravenous injection and intravenous pumping in the treatment of organophosphorus poisoning. Methods： 100 cases of organophosphorus poisoning patients admitted to our hospital from January 2016 to May 2018 were selected and divided into experimental group （n=50） and conventional group （n=50） according to the random number table method. The conventional group received intermittent intravenous atropine treatment， and the experimental group received continuous intravenous pump atropine treatment. Results： the symptom remission time and atropine treatment time in the experimental group were significantly lower than those in the conventional group （P<0.05）. There was no significant difference in cure rate between the two groups （P>0.05）. The incidence of rebound， overdose and sequelae in the experimental group was significantly lower than that in the conventional group （P<0.05）. Conclusion： continuous intravenous infusion of atropine for patients with organophosphorus poisoning can improve the curative effect， and the effect is faster， higher safety， worthy of wide promotion.

【 key words 】 continuous intravenous pumping; Intermittent intravenous injection; Atropine. Organophosphorus poisoning

农药通过胃肠道、黏膜、皮肤、呼吸道等入侵后，人体就会出现急性有机磷中毒，并且会向各个器官快速分布，胆碱酯酶活性会因此而降低，其分解乙酰胆碱能力也会丧失，由于聚集大量胆碱能神经化学介质乙酰胆碱，患者进一步产生中枢系统、蕈碱样及烟碱样症状，更有甚至因呼吸衰竭而死亡。有机磷中毒首选解毒剂为阿托品，过去应用该药物主要采用静脉推注的方法，阿托品化后按照延长时间不减量、减量不延长时间的原则治疗。当前临床常用给药方案包括阿托品持续静脉泵入、间断静脉注射，但对于两者疗效存在一定争议。基于此，本研究选择我院收治的有机磷中毒患者100例，对其中分别应用阿托品持续静脉泵入、间断静脉注射的给药方式，现报告如下。……