RÉSUMÉ
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.
RÉSUMÉ
Objective To explore the penehyclidine hydrochloride and pralidoxime chloride treatment application meth-ods of organophosphorus pesticide poisoning. Methods A total of 56 cases of hospitalized with oral route poisoning were selected in the study, aged more than 14 years old, without liver or kidney diseases and was not treated with counter-poison before hospitalization. The dose and time interval of medication was adjusted base on the clinical manifestations and the cholinesterase measurements. Results As the degree of poisoning aggravating, the total dosage and frequency of counterpoison increased. The time of achievement of atropinization was(25±8)min in mild intoxication patients,(78±17)minutes in moderate intoxication patients, and(186±54)min in severe intoxication patients. At one hour after treatment, the cholinesterase measurements was significant different compared with before the treatment(P<0.01). Conclusion The process of drug treatment can be divided into four stages, the first, second, repetition and maintain. Can not be given drugs with the fixed time and fixed quantity. Atropinization and cholinesterase measurements over 50% were two important index of full dose. Assessment, medication, and reassess were an important measure to prevent inadequate or excessive medication.
RÉSUMÉ
ObjectiveTo study the role of catecholamine in genesis of myocardium injury after organophosphorus poisoning (OP) in order to elucidate the underlying mechanisms of OP-induced cardiotoxicity.Methods Of 92 patients with severe acute dichlorvos poisoning,41 were consecutively enrolled for study and followed up for three months. The levels of serum creatine kinase isoenzyme myocardium (CK-MB),cardiac troponin Ⅰ (cTnI),acetylcholinesterase (AChE),acetylcholine (Ach),epinephrine and norepinephrine were assayed on the 1st,3rd and 5th days after admission and on the day of discharge.Electrocardiography was recorded every day after admission.ResultsOf them,37 (90.2％ )patients survived and four ( 9.8％ ) patients died during treatment.Sinus tachycardia was found in 37 (90.2％ ) patients and ST-T changes in 33 (80.4％ ) patients.CK-MB and cTnI levels peaked 3 days after admission,and then decreased to normal levels.Serum Ach,epinephrine and norepinephrine peaked on the 1st day after admission and then decreased.ConclusionsSevere acute dichlorvos poisoning is associated with myocardial dysfunction likely caused by increase in catecholamine levels.
RÉSUMÉ
Objective To investigate the therapeutic effect of continuous intravenous pralidoxime chloride infusion in acute organophosphorus pesticide poisoning(AOPP).Methods The patients with severe AOPP were randomly divided into 3 groups:(1)group 1(n =51)received a bolus injection of pralidoxime chloride 2.Og followed by continuous intravenous infusion at 0.25 g/h.(2)group 2(n = 51)received a bolus injection of pralidoxime 2.Og followed by continuous intravenous infusion at 0.5g/h.(3)group 3(n = 50)received intravenous drip of pralidoxime 2.Og for 3 times a day.Efficacy was compared among 3 groups on the basis of time to reach atropinization,recovery of cholinesterase activity .cumulative amount of atropine,incidence of recurrence of pesticide poisoning,intermediate syndrome,and hospitalization days,etc.Results Efficacy in patients receiving continuous intravenous therapy was significantly different from the third group.But there was no significant difference in efficacy between the first and second groups.Conclusion The patients with AOPP can be effectively treated by a loading dose followed with continous intravenous pralidoxime chloride infusion.