Résumé
Objective To improve the prognosis among patients with respiratory failure poisoned by organophosphorus pesticide though analyzing and discussing the emergency measures and treatment effects. Methods From January 2014 to December 2016, 86 patients with respiratory failure caused by severe organophosphorus pesticide poisoning were received in the Emergency Department in Nanchong Central Hospital.The patients were numbered according to the order of the treatment and randomly divided into control group and observation group with 43 cases in each group.All patients were treated with routine emergency measures (gastric lavage and endotracheal intubation, rehydration, and symptomatic treatment).The control group was treated with pralidoxime chloride injection and injection of atropine detoxification while the observation group was given pralidoxime chloride combined with Penehyclidine Hydrochloride Injection detoxification.We compared the alleviation of clinical symptoms and the changes of cholinesterase (CHE) and respiratory function (respiratory frequency, Pa02, Pa02/Fi02) between the two groups of patients 10 min and 30 min after administration. The statistics of atropinization time, blood purification treatment rate, tracheotomy rate, hospital mortality,complications and treatment time were recorded. Results No statistic significance was observed among the two groups of patients in gender,age, weight,body mass index (BMI),the severity of poisoning,types of organophosphorus drugs and blood cholinesterase (CHE) at the first visit (P＞0.05).Blood CHE was effectively improved among the two groups 10 min and 30 min after the treatment and significantly higher CHE was seen in the observation group compared to the control group (P＜0.05) . The overall clinical symptom rate was lower 10min and 30min after the treatment (P＜ 0.05), and the clinical symptom rate of the observation group was lower than that of the control group (P＜0.05) . The respiratory function indexes (respiratory rate, Pa02, Pa02/Fi02) were significantly improved 10 min and 30 min after the treatment in both groups compared with those before the treatment (P＜ 0.05) .The blood purification treatment rate, tracheotomy rate, complication rate, hospitalization time and atropine time of the observation group were significantly lower than those of the control group (P＜ 0.05) . No significant difference was found in mortality rate between the two groups (P＞0.05).Conclusion After giving effective respiration and circulation support, administration of penehyclidine hydrochloride combined with pralidoxime chloride detoxification can effectively restore the cholinesterase activity among patients with organophosphorus pesticide poisoning and improve respiratory function and prognosis, whichshows a high clinical value.
Résumé
Introduction: The effectiveness of first-aid measures (binding, incision and aspiration) for patients with habu bites and the indications of dry habu equine antitoxin for patients with habu bites are unclear. We investigated the relationships between first-aid measures and prognosis, and between symptoms (pain, swelling and bleeding) and antitoxin administration. Methods: We evaluated responses to a questionnaire submitted by 65 patients with habu bites. Patients who fully recovered were defined as "good", and those who had functional disorders, with or without rehabilitation, were defined as "bad." Fisher's exact test was used for analysis. Results: Pain was significantly related to antitoxin administration; however, swelling and bleeding were not related to antitoxin administration. First-aid measures and local symptoms were not related to prognosis. Conclusion: Our results revealed that many doctors determine the need for antitoxin administration according to pain. Moreover, our results suggested that the need for first-aid measures for patients is minimal. However, to clarify the indications for antitoxin administration and the effectiveness of first-aid measures for patients, further studies are warranted.