内科

目的探讨阿托品和纳洛酮微泵持续注射治疗重度急性有机磷农药中毒呼吸衰竭的临床疗效。方法将50例有机磷农药中毒呼吸衰竭患者，按双盲法随机分为治疗组与对照组各25例；治疗组在常规治疗的基础上以阿托品+纳洛酮微泵注入，对照组采用传统阿托品间隔静脉推注法。两组患者保持阿托品化状态7～10 d或更长，同时配合洗胃，使用复能剂氯磷定、解磷定，必要时采取有效携氧机械通气等内科综合治疗，观察记录两组患者阿托品用药总量、阿托品化时间、治愈时间、呼吸衰竭发生时间，死亡人数等。结果治疗组阿托品化时间、呼吸衰竭发生时间、病死率、阿托品用药总量及反跳发生率比对照组明显减少（P均＜0.05或0.01）。结论微泵注入阿托品及纳洛酮治疗重度有机磷农药中毒呼吸衰竭具有快速、足量、恒定、疗效快、且用药方法简单等优点。

ObjectiveTo explore the clinical efficacy of atropine and naloxone micropump continuous injection in the treatment of 25 cases of severe acute organophosphorus pesticide poisoning with respiratory failure.Methods50 cases of organophosphorus pesticide poisoning patients with respiratory failure double-blind randomly divided into treatment group and control group,each with 25 cases.Treatment group was given atropine plus naloxone microinfusion pump injection at the basis of conventional therapy,the control group was only with interval intravenous atropine injection.Two groups of patients were maintain atropine status of 7-10 d or longer,at the same time with gastric lavage,pralidoxime chloride and mechanical ventilation when necessary.Observed two groups of patients with atropine total drug administration,time of atropine,treatment time,respiratory failure occurred and mortality.ResultsTime of atropine,time of respiratory failure occurrence, mortality, inadequate dose of atropine and rebound the incidence in treatment was decreased significantly compared with the control group (P＜0.05 or 0.01).ConclusionMicropump injected atropine and naloxone treatment feature with fast,adequate,constant and effective and easy administration, it can shorten the time of atropine,reduce mortality,inadequate dose of atropine and incidence of rebound,combined with naloxone can effectively control the occurrence of respiratory failure.