作　　者： (王磊）; (唐泽海）; (陈奎）; (吕飞）; (樊红）; (孙鹏）; (韩继媛）;

机构地区： 华中科技大学同济医学院附属协和医院急诊科,武汉430022

出　　处： 《中华急诊医学杂志》 2017年第8期924-928,共5页

摘　　要： 目的通过对急性有机磷农药中毒患者氯解磷定用量分组，了解不同剂量的氯解磷定用量对治愈率、病死率等结局指标的影响。方法回顾性分析武汉协和医院自2004年1月至2014年12月收治的急性有机磷农药中毒患者163例，按照氯解磷定24h用量、氯解磷定总量进行分组，比较不同氯解磷定剂量组问患者的治愈率、病死率、平均住院时间、机械通气时间等结局指标。应用SPSS18．0进行统计学分析，计数资料组间对比采用X2检验Fisher精确概率计算法；计量资料组间对比采用独立样本t检验或单因素方差分析，以P〈0．05成差异有统计学意义。结果根据氯解磷定24h用量分组：实验组在治愈率及病死率方面均优于对照组（P=0．04）；而在住院时间上，实验组与对照组相比较差异无统计学意义（P=0．171）；剂量-反应关系分组中：治愈率及病死率四组之间差异具有统计学意义（P：0．034）。根据氯解磷定总量分组：实验组在治愈率及病死率方面均优于对照组（P=0．002）；剂量一反应关系分组中：治愈率及病死率三组之间差异具有统计学意义（P=0．006）。结论氯解磷定24h用量及氯解磷定总量增加，可提高治愈率，降低病死率。 Objective To investigate the effect of different doses of pralidoxime chloride on clinical outcome including recovery rate and mortality in patients with acute organophosphorus pesticide poisoning. Methods According to the total amount of pralidoxime chloride administered over the first 24 hours or entire duration of hospitalization, a cohort of 163 organophosphorus pesticide poisoning patients, admitted from February 2004 to December 2014 were assigned to different groups followed by a retrospective analysis. Comparisons of recovery rate, mortality rate, mean length of hospital stay, and duration of mechanical ventilation were made among groups. SPSS 18. 0 was used to analyze categorical variables between the data of groups with X2 test/Fisher exact probability method and numerical variables with t test or One-way ANOVA, and statistical significance was set as P 〈 0. 05. Results According to the amount of pralidoxime chloride given over the first 24 hours, the recovery rate and the mortality rate were significantly improved in the experimental group （pralidoxime chloride 〉 2 g） than in the control group （pralidoxime chloride 〈 2 g） （ P = 0. 04 ）. There was no significant difference in mean length of hospital stay between the experimental group and the control group （P = 0. 171 ） , and there were statistically significant differences in recovery rate and mortality rate among the four dose-response subgroups （ total dosage administered in 24 hours in group A 〈 1 g, in group B 〈2 g, in group C 〈4 g and in group D 〉4 g） （P =0. 034）. Based on the total amount of pralidoxime chloride prescribed in the entire duration of hospital stay, the recovery rate and mortality rate were significantly better in the experimental group than those in control group （ P = 0. 002） , and among the three dose-response subgroups, the significant difference in recovery rate and mortality rate were alsoobserved （P = O. 006）. Conclusions Increased amounts of pralidoxime chloride prescribed in th

关 键 词： 急性有机磷农药中毒 杀虫剂 农药中毒 胆碱酯酶复能剂 肟类化合物 氯解磷定 碘解磷定 解毒剂 剂量