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Objective To explore the effect of single blood perfusion combined with blood perfusion combined with continuous venous venous blood filtration (sequential blood purification) on myocardial injury in patients with severe acute organophosphorus pesticide poisoning.MethodsRetrospectively analyzed in July 2013 to July 2015 treated in our hospital see a doctor and a total of 94 patients with severe acute organophosphorus pesticide poisoning, depending on the patient's blood purification scheme, divided the patients into blood perfusion group (n=48) and sequential blood purification group (n=46), contrast after treatment on two groups of clinical curative effect, the condition of myocardial spectrum index and its complications.ResultsAfter treatment, blood perfusion group of left ventricular ejection fraction was (53.8±5.8)%, sequential left ventricular ejection fraction after blood purification treatment group was (58.1±3.4)%, both have obvious difference, has statistics meaning (P<0.05).In terms of myocardial enzyme spectrum index, and sequential blood purification group is obviously better than the index of myocardial enzymes in patients with blood perfusion group (P<0.05).The incidence of complications in patients with sequential blood purification group were lower than the blood perfusion group (P<0.05).ConclusionThe joint continuity venous blood perfusion-blood purification scheme of vein hemofiltration treatment of patients with severe acute organophosphorus pesticide poisoning can significantly improve treatment effect.
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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 also observed (P =0.006).Conclusions Increased amounts of pralidoxime chloride prescribed in the first 24 hours and in the whole hospitalized period can improve the recovery rate and reduce the mortality rate in organophosphorus pesticide poisoning patients.
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OBJECTIVE:To evaluate the economics of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus poisoning (AOPP).METHODS:The information of 118 AOPP patients were collected and divided into group A (59 cases) and B (59 cases) according to therapy plan.There were 22 cases of mild poisoning,20 cases of moderate poisoning and 17 cases of severe poisoning in group A.There were 21 mild cases,21 moderate cases and 17 severe cases in group B.Based on routine treatment,group A was given Penehyclidine hydrochloride injection intramuscularly with initial dose of 1 mg (mild),2 mg (moderate) and 4 mg (severe).Group B was given Atropine sulfate injection intravenously,with initial dose of 2 mg (mild),5 mg (moderate) and 10 mg (severe).Both received maintenance treatment according to patients condition and stopped taking medicine after symptoms disappeared.Clinical efficacies,the time of acetylcholinesterase recovery and ADR were observed in 2 groups.The economics of therapy plans for mild,moderate and severe poisoning were evaluated in 2 groups by cost-effectiveness analysis.RESULTS:There was no statistical significance in total response rate of mild poisoning or the time of acetylcholinesterase recovery between 2 groups (P＞0.05).Total effective rates of moderate and severe poisoning in group A were significantly higher than group B,and the time of acetylcholinesterase recovery was significantly shorter than group B,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR in mild,moderate and severe poisoning patients (P＞0.05).Cost-effectiveness ratio of penehyclidine hydrochloride was similar to that of atropine in mild poisoning patients;that of penehyclidine hydrochloride were significantly lower than that of atropine in moderate and severe patients.It was inline with the results of sensitivity analysis.CONCLUSIONS:Based on routine treatment,penehyclidine hydrochloride is similar to atropine in therapeutic efficacy of AOPP and the time of acetylcholinesterase recovery.For moderate and severe AOPP patients,penehyclidine hydrochloride is significantly better than atropine in improving therapeutic efficacy and the time of acetylcholinesterase recovery.The safety of 2 drugs are satisfactory;penehyclidine hydrochloride possesses cost-effectiveness advantage.
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Objective To investigate the changes in ATPase activity of diaphragm in rats with acute organophosphorus poisoning (AOPP) and to explore the effect of Xuebijing injection on the ATPase activity. Methods 24 clean healthy Spraue-Dawley(SD)rats were divided into control group,model group and Xuebijing treatment group by means of random number table,with 8 rats in each group. AOPP model was established by intra-gastrical administration of 50 mg/kg oxide dimethoate. In Xuebijing treatment group,after oxide dimethoate administration,intraperitoneal injection of Xuebijing(10 mL/kg)was given at the same time,while in control group and model group,equal amount of normal saline(NS)was injected via the same route. The rats were sacrificed at 6 hours after model formation,and their diaphragms were taken sterilely. The activities of Na+-K+-ATPase and Ca2+-ATPsae of diaphragms were detected by enzyme linked immunosorbent assay(ELISA). The histopathological changes in diaphragms of rats were observed with light microscopy. Results 6 hours after intoxication,the diaphragm Na+-K+-ATPase activity of rats in model group was markedly lower than that in control group(mmol?h-1?g-1:5.22±0.74 vs. 9.98±0.37,P<0.01),while the Na+-K+-ATPase activity in Xuebijing treatment group(6.93±1.14) was markedly higher than that in model group(P<0.05). The diaphragm Ca2+-ATPase activity of rats in model group was markedly lower than that in control group(mmol?h-1?g-1:7.45±0.74 vs. 12.08±0.74,P<0.01),while the Ca2+-ATPase activity in Xuebijing treatment group(9.35±1.67)was obviously higher than that in model group(P<0.05)after intoxication for 6 hours. Light microscope observation indicated that there were swelling and necrosis in diaphragm in model group,while in Xuebijing treatment group no necrosis was found. Conclusion The diaphragm was degenerated and necrotic in AOPP rats,Xuebijing injection can lessen the injury in such rats,and the curative effect may be related to the improvement of the Na+-K+-ATPase and Ca2+-ATPsae activities of diaphragm.
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Objective To investigate the clinical value of copeptin and ischemia modified albumin combined determination in the early diagnosis and clinical significance in myocardial damage of acute organic phosphorus pesticide poisoning .Methods Eighty‐six cases of AOPP patients were divided into two groups :the myocardial injury group (50 cases) and non myocardial injury group (36 cases) ;30 healthy people were selected as the control group .3 mL of venous blood were collected for all subjects involved within one hour in admission ,and their cTnI ,IMA and copeptin levels were detected .Results Compared with the control group ,the copep‐tin levels of non myocardial injury group and myocardial injury group were elevated and there was significant difference (P< 0 .05) ;the difference between myocardial injury group and non myocardial injury groups was also significantly different (P< 0 .05) .Among them ,the comparison between severe and mild to moderate group revealed that the IMA and copeptin levels reduced obviously ,there was significant difference (P< 0 .05) ;in myocardial injury group ,the IMA and copeptin levels of patients in different poisoning de‐gree were negatively correlated .Conclusion Early determination of IMA and copeptin level has important significance in the early diagnosis of myocardial injury in patients with poisoning in AOPP ,and could provide guidance for clinical medication .
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Objective To investigate the effects of hemodynamic,prognostic effect and myocardial protection of Salvia injection on patients with acute organophosphorus pesticide poisoning. Methods 68 cases of patients with acute organophosphate were divided into observation group(n=34)and control group(n=34) from January 2012 to December 2013.The control group were given with atropine detoxification (dose:5-10mg), Tiopronin (0.2 g/d, 1 times/d) liver treatment, Pioneer will(2 g/second,1/d).The observed group received the foundation treatment and Salvia injection(30ml, 1/d), 7d course of treatment. The myocardial enzymes and hemodynamic parameters of two groups were observed before and after treatment. Results The survival rate and died rate of observation group were 94.12%(32 cases ), 5.88%(2 cases ). The survival rate and died rate of control group were 79.41%(27cases )and 20.59%(7cases). The survival rate and died rate of two groups were significant difference (χ2=5.123, P<0.05). The myocardial enzymes (AST, CK, CK-MB, LDH, HBDH) of observation groupafter 2d each index[were(58.6±22.7)U/L, (412.6±156.9)U/L, (78.6± 35.2)U/L, (489.3 ± 112.3)U/L, (412.8 ± 259.6)U/L] and blood rheology (ESR, FIB, LBV, HBV)each index[were(14.36±4.19) mm/h before , (259.3±23.14)g/L, (7.17±1.12)mPa?s, (4.12±0.81)mPa?s]were lower than in the same group therapy [myocardial enzymes indexes were (131.3±32.5)U/L, (1324.5± 345.2)U/L, (187.5 ± 72.2)U/L, (914.5 ± 312.2)U/L, (812.3 ± 312.2)U/L; hemorheology indexes were (23.29±3.49)mm/h, (389.57±34.24) g/L, (10.4±1.3)mPa?s, (6.3±1.2)mPa?s]. 5 d after treatment control group myocardial enzymes(AST, CK, CK-MB, LDH, HBDH)each index[were(85.3±22.8)U/L, (486.3± 78.9)U/L, (67.8±11.2)U/L, (542.3±78.6)U/L, (225.9±112.4)U/L]and hemorheology indexes[were(17.7± 4.6)mm/h, (289.4±32.5)g/L, (8.9±1.2)mPa?s, (5.6±1.3)mPa?s] was significantly lower than in the same group before treatment[myocardial enzymes indexes were(128.3±29.3)U/L, (1298.6±329.4)U/L, (182.6± 70.6)U/L, (902.3±286.3)U/L, (803.6±293.6)U/L;hemorheology indexes were (23.9±3.5)mm/h, (382.6± 32.5)g/L, (10.3±1.1)mPa?s, (6.2±1.1)mPa?s, P<0.05]. Conclusion Salvia injection can effectively improve the hemodynamic indicators of acute organophosphorus pesticide poisoning patients , reduce myocardial damage, promote patient prognosis.
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Objective To explore the prognostic value of APACHE Ⅱscore in patients with Severe acute organophosphorus poi-soning .Methods 42 patients with Severe acute organophosphorus poisoning ,in which 34 cases survived ,8 cases dead ,were select-ed .The APACHE Ⅱscores of patients in first 24 h of admission were collected ,and receiver operating characteristic curves (ROC curve) were drawn .Results APACHE Ⅱ score of the 42 patients with Severe acute organophosphorus poisoning was 18 ~30 (20 .11 ± 6 .32) ,in which the survival group was(16 .10 ± 3 .12) ,the dead group was(28 .01 ± 4 .46) (P<0 .01) .With the increase of APACHE Ⅱ score ,the fatality rate gradually increased .The total area under the ROC curves of APACHE Ⅱ score for death judgment was 0 .922 ,APACHE Ⅱ score of 21 .2 was the best diagnostic point ,the sensitivity was 95% ,and specificity was 89% . Conclusion The APACHE Ⅱscore could predict severity of patients with Severe acute organophosphorus poisoning ,and APACHEⅡscore ≥21 .2 could be used as the prognosis for death of the patients .
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Objective To investigate the extubated timing in acute severe organophosphorus pesticide poisoning patients.Methods Seventy-five patients with mechanical ventilation for acute severe organophosphorus pesticide poisoning were divided into early group (34 cases) and late group (41 cases) by extubation time.Mechanical ventilation time,ICU retention time,tracheal intubation time,ventilator-associated pneumonia (VAP) incidence and extubation success rate of both groups were observed.Results The mechanical ventilation time,ICU retention time between two groups showed no significant difference [(110.66±28.59)h vs.(114.47±34.21)h,(140.63±28.52)h vs.(138.44±34.74) h,P＞0.05].The tracheal intubation time in late group was significantly longer than that in early group [(135.27 ± 28.84) h vs.(119.03 ± 35.05) h,P ＜ 0.05],but the VAP incidence was nostatistically significant difference between two groups [29.27％ (12/41) vs.20.59％ (7/34),P ＞ 0.05].The success rate of extubation in late group was significantly higher than that in early group [97.56％ (40/41) vs.79.41％ (27/34),P ＜ 0.05].Conclusion Delayed extubation can significantly improve the chances of successful extubation,and no increase in VAP risk and more secure in acute severe organophosphorus pesticide poisoning patients.
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Objective To discuss the correlations between hemoperfusion(HP) times and therapeutic effects/prognosis in patients with severe acute organophosphorus poisoning(AOPP). Methods According to the frequency of HP,82 patients with severe AOPP were divided into three groups:non HP(25 cases),HP1(27 cases) and HP2(30 cases)groups. The non HP group received only routine treatment,on the basis of routine treatment,the HP1 group accepted once HP within 12 hours after poisoning and the HP2 group underwent twice or more times of HP,the interval between each time being 24 hours. The comparisions of clinical indexes,incidences of complications and rates of mortality among the three groups were performed. Results With the increase of HP times,the dosages of atropine and pralidoxime chloride were significantly reduced,the times of serum cholinesterase(ChE)activity recovery,consciousness recovery,hospitalization and mechanical ventilation were significantly shortened,the score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in 48 hours after admission,incidence of complications and mortality were evidently decreased(all P<0.05). Compared with those in HP1 group,the dosages of atropine(mg:164.57±68.82 vs. 256.81±97.06)and pralidoxime chloride(mg:6.95±1.40 vs. 8.76±1.64) in HP2 group were significantly reduced,the times of ChE activity recovery(day:9.03±2.46 vs. 10.96±3.44), consciousness recovery(hour:23.83±6.29 vs. 39.93±8.24),hospitalization(hour:9.57±2.39 vs. 11.52±3.02) and mechanical ventilation(hour:40.50±16.55 vs. 65.74±18.88)in HP2 group were significantly shortened;APACHEⅡscore during 48 hours after admission(11.97±3.47 vs. 14.26±2.88)was obviously decreased,and the incidences of complications,such as intermediate syndrome(10.0% vs. 18.5%),rebound phenomenon(3.3% vs. 25.9%),arrhythmia(13.3%vs. 44.4%),multiple organ dysfunction syndrome(MODS,6.7%vs. 29.6%)and mortality rate(6.7% vs. 18.5%)in HP2 group were markedly decreased(all P<0.05). Conclusion It is recommendable that combined with routine treatment,early and multiple HP application would enhance the therapeutic effect and decrease the mortality in patients with severe AOPP.
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Objective To explore the variation and clinical significance of serum cardiac troponin I (cTnI) and interleukin-6 (IL-6) in patients with acute organophosphorus pesticide poisoning (AOPP).Methods The serum cTnI and IL-6 levels in 97 patients with AOPP(AOPP group) and 40 healthy subjects (control group) were tested by double antibody sandwich enzyme linked immunosorbent assay and compared between two groups.Results The serum cTnI and IL-6 levels in AOPP group on admission,admission 1,3 d were respectively (2.51 ± 0.80),(2.11 ± 0.67 ),( 1.58 ± 0.50) μ g/L and ( 154.82 ± 49.15 ),( 139.33 ± 44.23),(108.37 ± 34.40) ng/L,which were higher than those in control group [(0.02 ± 0.01 )μ g/L,(82.61 ± 26.23) ng/L] (P ＜ 0.05).The serum cTnI and IL-6 levels increased with increasing degrees of poisoning.The different degrees of poisoning was positively correlated with the serum cTnI and IL-6 levels (r =0.642,0.517,P ＜ 0.05).Conclusions The degrees of poisoning,myocardial damage and inflammatory reaction of AOPP patients are closely related to the serum cTnI and IL-6 levels.The dynamic observation of the serum cTnI and IL-6 levels has an important significance for the judging the severity of myocardial damage and inflammatory reaction of AOPP patients.
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Objective To explore the relationship between serum cardiac troponin I (cTnI) and high sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-alpha (TNF-α ) in patients with acute organophosphorus pesticide poisoning (AOPP) and their clinical significance.Methods One hundred and twelve patients with AOPP (without sudden death ) were as AOPP group.One hundred and twelve healthy controls were as control group.Serum cTnI,hs-CRP and TNF-α levels were determined by ELISA and compared between two groups.The relationship between serum cTnI and hs-CRP,TNF-α was analyzed.Time for atropinization and acetylcholinesterase activity recovery and days of hospitalization were observed.The effectiveness of AOPP patients in different serum cTnI levels was compared.Results Serum cTnI,hs-CRP and TNF- α levels in AOPP group[0.75 (0.26,0.99) μ g/L,11.57(5.13,21.62) mg/L,( 12.36 ±5.22) μ g/L] were higher than those in control group[0.01 (0,0.03) μ g/L,3.62(2.31,6.80) mg/L,(7.33 ±4.31 ) μ g/L] (P ＜ 0.01 ).Serum cTnI levels were positive correlation with serum hs-CRP and TNF- α levels in AOPP patients (r =0.53,0.62,P ＜ 0.01 ).Time for atropinization and acetylcholinesterase activity recovery and days of hospitalization in higher serum cTnI levels patients ( 56 cases ) [(7.31 ± 1.96),( 15.29 ± 3.66 ),(17.23 ± 3.62) d] was longer than that in lower serum cTnI levels patients (56 cases)[(5.32 ± 1.03),( 11.32 ± 2.59),( 13.66 ± 3.03) d](P＜ 0.01).Conclusions Cardiac insults in AOPP patients are related to inflammation.Sudden death-free AOPP patients with higher cTnI levels have less response to treatments.
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Objective In order to extrapolate the respiratory dysfunction of patients in early stage of acute organophosphorus pesticide poisoning (AOPP),transpulmonary thermodilution technique was used in swine models of severe acute dichlorvos poisoning (SADP) to evaluate respiratory function.Methods Twenty healthy female swine were randomly divided into dichlorvos ( n =7 ),atropine ( n =7 ) and control (n =6) groups.In the dichlorvos group,the swine were administered with 80％ emulsified dichlorvos (100mg/kg) via the gastric tube toinduce SADP.In the atropine group,swinewere administered with dichlorvos,and 0.5h later,atropine was injected to obtain and maintain atropinization.The swine of control group were administered with saline solution instead.Arterial and venous blood samples were collected 0,0.5,1,2,4 and 6 hours after modeling for blood gas analysis and detecting acetylcholinesterase levels.Both extravascular lung water index (EVLWI) and pulmonary vascular permeability index ( PVPI ) were measured by using PiCCO (pulse indicator continuous cardiac output ). At the termination of the experiment,the animals were sacrificed and the lung wet/dry weight ratio was determined and histopathological changes of lung tissue were also observed under microscope.Results In the dichlorvos group,EVLWI and PVPI were substantially increased from 0.5 h to 6 h after modeling but PaO2/FiO2 decreased from 0-6 h after modeling.In the atropine group,EVLWI and PVPI increased initially,but then they decreased 1 h afterwards and PaO2/FiO2 was also gradually decreased from 0-1 h.In both dichlorvos group and atropine group,the EVLWI was negatively correlated with PO2/FiO2 and positively correlated with PVPI.Compared with the control group,the lung wet/dry weight ratio increased markedly in the dichlorvos group and mildly increased in the atropine group.Meanwhile,the histopathological changes of lung tissue were obvious in the dichlorvos group and mild in the atropine group.Conclusions SADP swine experienced substantial changes in respiratory function. EVLWI was a reliable and valuable indicator for evaluating respiratory function in the early stage of AOPP.
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Objective To explore the therapeutic effect of lipid emulsion on acute organophosphorus poisoning and its consequence of acute lung injury. Methods A total of 48 sealant - grade Sprague-Dawley (SD) rats were randomly divided into four groups A,B,C,D,namely saline control group,lipid emulsion control group,the conventional therapy group and lipid emulsion administration group. After dichlorvos (DDVP) 11 mg/kg was given by intra-peritoneal injection,if there was no loss of DDVP during the injection process,the model of poisoning was considered to be made successfully.Then the rat models in four groups were respectively treated:with normal saline (5 ml/kg) intravenous injection in group A,lipid emulsion (5ml/kg) intravenous injection in group B,atropine (5 mg/kg) and pralidoxime chloride (40 mg/kg) intramuscular injection in group C,and combined use of lipid emulsion (5 ml/kg) with atropine and pralidoxime chloride in group D after administration of DDVP by intra-peritoneal injection.The activity of cholinesterase (CHE) in blood was detected before and 0.5 h,2 h and 4 h after DDVP poisoning. The clinical manifestations,the survival of rats,the wet weight of rat' s lung and the pathological changes of the lung tissue were observed within following 24 h. The rates of survival and symptoms of rats were compared between paired groups by using the x2 test,and the mean values of biomarkers were compared paired groups by using t test. Results In groups A and B,the intensity of muscular fasciculation and salivation were more severe and appeared sooner after DDVP exposure in comparison with groups C and D leading to lower survival rates in group A and B. Compared with group C,the rate of 24 h survival was higher and the intensity of muscular fasciculation was weaker in group D ( P ＜ 0.05 ).In group A and group B,the 24-hour survival rates were 1/12 and 2/12,respectively ( P ＜ 0.05 ).The levels of CHE in blood significantly decreased after DDVP poisoning ( P ＜ 0.05 ).There was no significant difference in activity of CHE between group B and group A,and in groups C and D,the levels of CHE in blood were not significantly higher than that in the group B 0.5 h after DDVP poisoning ( P ＜ O.05 ).In groups C and D,the activity of CHE in blood was significantly higher compared with group A and B,and that in group D was higher compared with C,and that in group B was higher compared with A 2 and 4 hours after DDVP poisoning ( P ＜ 0.05 ).In groups C and D,the wet weight of rat lung was significantly lighter compared with groups A and B,and that in group D was lighter compared with C,and that in group B was lighter compared with A 24 h after DDVP poisoning P ＜ 0.05 ).The electron microscopic findings showed the combined use of lipid emulsion with atropine and pralidoxime chloride obviously lessened the lung histopathologic changes after DDVP poisoning.Conclusions The lipid emulsion combined with atropine and pralidoxime chloride can be beneficial to controlling the toxic symptoms,reduce the death rate,accelerate the resume of the activity of CHE in blood,and relieve the lung injury induced by acute organophosphorus poisoning.
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Objective To investigate the expression and clinical significance of early-stage serum interieukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in patients with acute organophosphorus pesticide poisoning (AOPP). Method 186 cases of AOPP were divided into mild group, moderate group and severe group according to the severity. 30 healthy volunteers served as control group. APACHE Ⅱ scores were evaluated for these patiences and their serum concentrations of IL-10 and TNF-α were detected by enzyme-linked immunosorbent assay (ELISA). Results APACHE Ⅱ scores increased significantly with the exacerbations of AOPP (P ＜0. 05). The serum IL-10 concentrations of AOPP was slightly higher than the control group. There was no significant difference compared with the control group (P ＞0. 05). APACHE Ⅱ scores positively correlated with the serum TNF-α concentrations, but not with the serum IL-10. However,the ratio of TNF-α and IL-10 positively correlated with APACHE Ⅱ scores ( P ＜ 0. 01 ). Conclusions There were pro-inflammatory response and anti-inflammatory response in patients with AOPP. Overrelease of inflammation promoting factor and imbalance between inflammation promoting and inhibiting factors correlated with the severity of AOPP, which may be an important mechanism of multiple organ dysfunction syndrome of AOPP.
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Objective To study the effect of oral administration of activated charcoal and mannitol on removing toxicant after acute organophosphorus pesticide poisoning (AOPP). Method A total of 41 patients with severe AOPP were randomly divided into experiment group (activated charcoal used as adsorbent and mannitol used as cathartics, n =21)and control group (without adsorbent and cathartics, n = 20). Patients of both groups received routine treatment for AOPP after admission to hospital. The differences in duration of atropinization, the length of hospitalization and the success rate of treatment were compared between two groups. Results There were significant differences in duration of atropinization, the success rate of treatment and hospitalization time between the two groups. Conclusions The combination of activated charcoal and mannitol is more effective than the conventional gastric lavage on removal of organophosphorus pesticides from G-I tract, shorting the duration of atropinization time and hospital stays, and enhancing the success rate of rescue as well as improving the outcome of patients after organophosphorus pesticide poisoning.
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Objective To observe the effects of long-acting Tuoning and atropine in the treatment of acute organophosphorus pesticide poisoning(AOPP).Methods A total of 97 cases of AOPP were randomly divided into therapy group(n=50) and control group(n=47).Therapy group were treated with long-acting Tuoning combined with pyraloximin methochloridum,and control group were treated with atropine and pyraloximin methochloridum.The effects were compared.Results Long-acting Tuoning could shorten the time of apparent manifestation of AOPP(M-like symptom disappearance time was 1.2h in therapy group and 5.0h in control group,with a significant difference,P
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Objective To investigate the correlated clinical factors of upper gastrointestinal hemorrhage induced by acute organophosphorus pesticide poisoning(AOPP) and look for effective method for the prevention and treatment of upper gastrointestinal tract bleeding(UGTB).Methods 49 patients with severe AOPP were divided into UGTB group(group A,26 cases)and non-UGTB group(group B,23 cases).The time,frequency and causes of UGTB were observed.We also observed the differences in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),blood glucose and cholinesterase in serum.Results The causes of UGTB induced by AOPP were poison damage of stomach mucous membrane,gastric lavage damage and irritability ulcer;APACHE Ⅱ scores of group A were more than those of group B obviously;the level of cholinesterase was lower in group A.Correlation analysis showed that the APACHE Ⅱ scores had positive correlation and the level of cholinesterase had negative correlation with UGTB induced by AOPP.Conclusion Both the APACHE Ⅱ scores and level of cholinesterase can reflect the UGTB induced by AOPP.Active treatment of the primary disease and stress status and often the operation of gastric lavage are important ways to prevent and treat UGTB induced by AOPP.
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0.05), but the symptom of fever and character of respiratory tract's secretion of the patients in experiment group took turns for better obviously than the control group's ( P