2018 年第 5 期 第 13 卷

奋乃静片联合血液净化治疗急性有机磷农药中毒患者的临床效果及对精神障碍发生率的影响

Clinical effect of perphenazine tablets combined with blood purification on acute organophosphorus poisoning and the incidence of mental disorder

作者：谢胜祥曾凡杰孙振锐朱文友

英文作者：

单位：510010广州军区广州总医院急诊科(谢胜祥、曾凡杰、孙振锐);510168广州中医药大学金沙洲医院急诊科（朱文友）

英文单位：

关键词：农药中毒；精神障碍；奋乃静片；血液净化

英文关键词：

• 摘要：

• 目的    探讨奋乃静片联合血液净化治疗急性有机磷农药中毒患者的临床效果及对精神障碍发生率的影响。方法    选取广州军区广州总医院2010年1月至2016年12月收治的急性有机磷农药中毒患者58例，应用随机数字表法分为2组，各29例。对照组在常规洗胃、解毒、利尿、心电复苏、心电监护等对症治疗基础上采用血液净化治疗，观察组在对照组治疗基础上给予奋乃静片口服治疗，观察2组患者的临床疗效及治疗后精神障碍并发症的发生情况。结果    2组患者抢救成功率、昏迷时间、胆碱酯酶恢复时间比较差异均无统计学意义（均P＞0.05），但观察组住院时间明显短于对照组［(10.7±2.2)d比（13.5±2.5）d］，差异有统计学意义（P<0.001）；随访2个月期间，观察组患者精神障碍并发症发生率明显低于对照组［6.9%(2/29)比37.9%（11/29）］，差异有统计学意义（P=0.005）。结论    奋乃静片联合血液净化治疗急性有机磷农药中毒的临床效果与单纯血液净化治疗相当，但精神障碍并发症发生率明显降低，具有较好的预后。

• 【Abstract】Objective    To investigate the clinical effect of perphenazine tablets combined with blood purification on acute organophosphorus poisoning（AOPP） and the incidence of mental disorder. Methods    A total of 58 AOPP patients were enrolled from January 2010 to December 2016 in General Hospital of Guangzhou Military Command of People′s Liberation Army; they were randomly divided into control group and observation group, with 29 patients in each group. The control group was treated by blood purification; the observation group was treated by perphenazine tablets combined with blood purification. Clinical curative effect and occurrence of mental disorder were analyzed. Results    There were no significant differences of rescue success rate, coma time and cholinesterase recovery time between groups(P>0.05). Hospital stay time in observation time was significantly shorter than that in control group［(10.7±2.2)d vs （13.5±2.5）d］(P<0.001). Incidence of mental disorder in observation group was significantly lower than that in control group［6.9%(2/29) vs 37.9%（11/29）］(P=0.005). Conclusion    Perphenazine combined with blood purification is effective in lowering the incidence of mental disorder after AOPP.

  【Key words】Organophosphorus poisoning;Mental disorder;Perphenazine;Blood purification