Clinical Study On Treatment Of Severe Acute Organophosphorus Pesticide Poisoning By Atropin And Penehyclidine Hydrochloride Combined With Hemoperfusion

Objctive:Acute organophosphorus pesticide poisoning(AOPP) is a kind of common disease in countryside of China. The mortality rate of large dosage self-oral-poisoning with organophosphate pesticides is high. This paper aimed to investigate the adverse reaction and clinical efficacy of atropine, penehyclidine hydrochlorid, atropine and penehyclidine hydrochloridin acute severe organophosphorus pesticide poisoning(ASOPP) while combining with hemoperfusion.Method:All 150 patients with ASOPP were randomizedly assigned into three groups including atropine group, penehyclidine hydrochlorid group, atropine and penehyclidine hydrochloridin group. All patients were treated by removing poison, using pralidoxime chloride, hemoperfusion and supportive treatment. Incidence of anticholine poisoning, restlessness, hyperpyrexia, nodal tachycardia, atropine dependence and the complication rate, time of atropinzation, time of gastrointestinal function recovery, time of recovery of cholinesterase(Ch E) activity to 60%, the cure rate, and mortality rate in three groups were analyzed.Result: In penehyclidine hydrochlorid group, atropine and penehyclidine hydrochloridin group incidence of anticholine poisoning and atropine dependence were fewer than atropine group, and the differences were statistically significant(P<0.05). All groups have appeared restlessness, and the differences had no statistical significance among groups(P>0.05).Incidence of hyperpyrexia in penehyclidine hydrochlorid group, atropine and penehyclidine hydrochloridin group were fewer than atropine group, and the differences were statistically significant(P<0.05), had no statistical significance between penehyclidine hydrochlorid group and atropine and penehyclidine hydrochloridin group(P>0.05). Incidence of nodal tachycardia in penehyclidine hydrochlorid group, atropine and penehyclidine hydrochloridin group were fewer than atropine group, and the differences were statistically significant(P<0.05); penehyclidine hydrochlorid group fewer than atropine and penehyclidine hydrochloridin group, had statistical significance between two groups(P>0.05). Contrast with atropine group, the complication rate, time of gastrointestinal function recovery, and time of recovery of cholinesterase(Ch E) activity to 60% were lower and shorter, mortality rate were lower in penehyclidine hydrochlorid group, atropine and penehyclidine hydrochloridin group, and all the differences were statistically significant(P<0.05). Time of atropinzation was shorter in atropine group, atropine and penehyclidine hydrochloridin group compared with penehyclidine hydrochloridin group, the differences were statistically significant(P<0.05), had no statistical significance between atropine group and atropine and penehyclidine hydrochloridin group(P>0.05). Compared with penehyclidine hydrochlorid group, atropine and penehyclidine hydrochloridin group had fewer complication rate, lower mortality rate, and all the differences were statistically significant(P<0.05). Time of gastrointestinal function recovery, time of recovery of cholinesterase(Ch E) activity to 60% had no statistical significance between penehyclidine hydrochloridin group and atropine and penehyclidine hydrochloridin group(P>0.05).Conlusion: In treatment of ASOPP by atropine combined with penehyclidine hydrochloridin was more significant, with fewer adverse ractions while using hemoperfusion.