盐酸戊乙奎醚与阿托品联用救治急危重症急性有机磷农药中毒的疗效分析

Efficacy Analysis of Pentanethypibeine Hydrochloride Combined with Atropine in the Treatment of Acute Organophosphorus Pesticide Poisoning

摘要: 目的：探讨盐酸戊乙奎醚与阿托品联用救治急危重症急性有机磷农药中毒的临床疗效与安全性。方法：根据纳入和排除标准，回顾性筛选2021年01月至2023年03月于新疆生产建设兵团第三师总医院急诊科就诊的60例急性有机磷农药中毒患者，根据不同用药分成对照组和治疗组，对照组(n = 30)予以盐酸戊乙奎醚单用，治疗组(n = 30)在对照组治疗基础上加用阿托品，观察2组患者在治愈率、阿托品化时间、反跳发生率、胆碱酯酶活性恢复达70%的时间、中间综合征发生率、呼吸机使用时间、并发症发生率及住院费用的差异。结果：① 治疗前资料：两组患者的年龄、性别构成、身体质量指数、高血压、糖尿病、冠心病等进行比较，差异均无显著性意义(P > 0.05)。② 对照组阿托品化时间明显长于治疗组，(47.26 ± 2.96) min vs. (27.81 ± 1.70) min (P < 0.001)；对照组CHE恢复达70%的时间显著长于治疗组，(6.60 ± 1.26) d vs. (3.32 ± 1.15) d (P < 0.001)；对照组呼吸机使用时间明显长于治疗组，(6.82 ± 1.23 d vs.) (3.83 ± 1.26) d (P < 0.001)；对照组住院费用明显高于治疗组，(9466.92 ± 467.31) rmb vs. (6577.32 ± 672.92) rmb (P < 0.001)；对照组总并发症发生率14例，治疗组5例，差异存在统计学意义(P < 0.05)；两组治愈率差异无统计学意义，P > 0.05。结论：结果表明，联合应用盐酸戊乙奎醚与阿托品在治疗急性重度有机磷农药中毒(AOPP)时，相较于单独使用盐酸戊乙奎醚，其达到药效的时间更短，展现出显著的疗效。此外，这种联合用药方案能大幅度降低并发症的发生率，从而显著提升了急性有机磷农药中毒患者的救治成功率，是一种既安全又可靠的治疗方法。

Abstract: Objective: To investigate the clinical efficacy and safety of erytrophenine hydrochloride for acute organophosphorus pesticide poisoning. Methods: According to the inclusion and exclusion criteria, Retrospective screening of 60 patients with acute organophosphorus pesticide poisoning who presented to the Emergency Department of the General Hospital of the Third Division of Xinjiang Production and Construction Corps from January 2021 to March 2023, divided into control and treatment groups according to different medication, the control group (n = 30) used pentine hydrochloride alone, the treatment group (n = 30) added atropine to the control group treatment to observe the differences in cure rate, time to atropine treatment, incidence of rebound, recovery of cholinesterase activity at 70% time, incidence of intermediate syndrome, duration of ventilator use, complication rate and hospitalization costs. Results: ① Pre-treatment data: Comparison of age, gender composition, body mass index, hypertension, diabetes, and coronary heart disease between the two groups showed no significant differences (P > 0.05). ② The atropineization time in the control group was significantly longer than that in the treatment group (47.26 ± 2.96 min vs. 27.81 ± 1.70 min), P < 0.001; the CHE recovery time in the control group reached 70% significantly longer than that in the treatment group (6.60 ± 1.26 days vs. 3.32 ± 1.15 days), P < 0.001; the ventilation duration in the control group was significantly longer than that in the treatment group (6.82 ± 1.23 days vs. 3.83 ± 1.26 days), P < 0.001; hospitalization costs in the control group were significantly higher than those in the treatment group (9466.92 ± 467.31 RMB vs. 6577.32 ± 672.92 RMB), P < 0.001; the total complication rate in the control group was 14 cases compared to 5 cases in the treatment group, showing statistically significant difference (P < 0.05); there was no statistically significant difference in cure rates between the two groups, P > 0.05. Conclusion: The results showed that the combined application of pentyl ethyl ether hydrochloride and atropine in the treatment of acute severe organophosphorus pesticide poisoning (AOPP), compared with the use of pentyl ethylene ether hydrochloride, the efficacy time is shorter, can effectively prevent cholinesterase aging, required dosage less, while efficacy maintenance time is longer, showing significant curative effect. In addition, this combination regimen can greatly reduce the incidence of complications, thus significantly improving the success rate of patients with acute organophosphorus pesticide poisoning, which is a safe and reliable treatment method.