长托宁与阿托品联用救治急危重症AOPP的疗效分析

Analysis on Treatment Effect of Severe AOPP Combining Penehyclidine Hydrochloride and Atropine

摘要: 目的：观察盐酸戊乙奎醚(长托宁)与阿托品联用救治急危重症AOPP的临床疗效。方法：回顾性分析本院2012年1月至2015年10月急救中心收治的180例危重度AOPP患者的临床资料。观察组选用阿托品快速达化后续以长托宁维持体内抗胆碱药物浓度，对照组单用长托宁，两组均辅以氯磷定注射液及快速清除毒物等一系列救治措施，每组90例。分析各组阿托品化时间、胆碱酯酶(ChE)活性恢复达70%的时间、并发症发生率、住院费用、治愈率等指标。结果：观察组阿托品化时间(26.1 ± 14.7) min，ChE活性恢复70%时间为(4.0 ± 1.1) d，并发症发生率(1.11 (1))，平均住院日(5 ± 1.2) d，住院费用(6268 ± 238)元，治愈率(100.00 (90))；对照组阿托品化时间(43.7 ± 21.8) min，ChE活性恢复70%时间为(6.0 ± 2.3) d，并发症发生率(6.67 (6))，平均住院日(9 ± 1.5) d，住院费用(7921 ± 230)元，治愈率(96.67 (87))。观察组与对照组之间的观察指标均差异具有统计学意义(P < 0.01)。结论：长托宁与阿托品联用救治急危重症AOPP较长托宁达化时间短，胆碱酯酶不易老化，用药剂量少，药效持续时间长，疗效显著，并发症发生率低，显著提高AOPP患者救治成功率，安全可靠。

Abstract: Objective: To observe on treatment effect of severe AOPP combining penehyclidine hydrochloride (Changtuoning) and atropine. Methods: The clinical data of 180 patients with severe AOPP who were admitted to our hospital from January 2012 to October 2015 were analyzed retrospectively. Observation group used atropine and quickly achieved follow-up to maintain penehyclidine hy-drochloride in vivo anticholinergic drug concentration, while control group used penehyclidine hydrochloride. Two groups were supplemented with a series of rescue measures of chlorine and phosphorus fixed injection, quickly removing the poison, etc.; there were 90 cases in each group. The atropine time, the time of the ChE activity recovery reaching 70%, complication rate, hospita-lization expenses, cure rate, and some other indexes were analyzed. Results: In the observation group, the atropine time was (26.1 ± 14.7) min, the time of the ChE activity recovery reaching 70% was (4.0 ± 1.1) d, the complication rate was (1.11 (1)), the average hospitalization days were (5 ± 1.2) d, the cost of hospitalization was (6268 ± 238 yuan), and the cure rate was (100.00 (90)). In the control group, the atropine time was (43.7 ± 21.8) min, the time of the ChE activity recovery reach-ing 70% was (6.0 ± 2.3) d, the complication rate was (6.67 (6)), the average hospitalization days were (9 ± 1.5) d, the average hospitalization days were (7921 ± 230 yuan), and the cure rate was (96.67 (87)). The differences of the indicators between the observation group and the control group were statistically significant (P < 0.01). Conclusion: Using penehyclidine hydrochloride combined with atropine for treating severe AOPP critically costs shorter time; cholinesterase is not easy to aging; dosage is less; effect lasts longer; curative effect is remarkable; complication rate is low. It is proved that this treatment can significantly improve the success rate of treating AOPP patients, and is safe and reliable.