【摘要】：目的:評價戊乙奎醚與阿托品治療急性有機磷農(nóng)藥中毒(AOPP)的經(jīng)濟性。方法:收集118例AOPP患者資料,按治療方案的不同分為A組(59例)和B組(59例),其中A組輕度22例、中度20例、重度17例;B組輕度21例、中度21例、重度17例。在常規(guī)治療的基礎(chǔ)上,A組患者肌內(nèi)注射鹽酸戊乙奎醚注射液首次劑量1 mg(輕度)、2 mg(中度)、4 mg(重度),B組患者靜脈注射硫酸阿托品注射液首次劑量2 mg(輕度)、5 mg(中度)、10 mg(重度),兩組均視情況給予維持治療待癥狀消失后停藥。觀察兩組患者的臨床療效,乙酰膽堿酯酶恢復(fù)時間及不良反應(yīng)發(fā)生情況。采用成本-效果分析方法評定兩組輕、中、重度患者用藥方案的經(jīng)濟性。結(jié)果:兩組輕度中毒患者總有效率、乙酰膽堿酯酶恢復(fù)時間比較,差異均無統(tǒng)計學(xué)意義(P0.05)。A組中、重度中毒患者總有效率均顯著高于B組,乙酰膽堿酯酶恢復(fù)時間均顯著短于B組,差異均有統(tǒng)計學(xué)意義(P0.05)。兩組輕、中、重度患者不良反應(yīng)發(fā)生率比較,差異均無統(tǒng)計學(xué)意義(P0.05)。輕度中毒患者,戊乙奎醚與阿托品的成本-效果比相當;中、重度中毒患者,戊乙奎醚的成本-效果比均顯著低于阿托品。敏感度分析結(jié)果與一致。結(jié)論:在常規(guī)治療的基礎(chǔ)上,戊乙奎醚與阿托品治療輕度AOPP患者的療效、乙酰膽堿酯酶恢復(fù)時間均相當,對于中、重度AOPP患者戊乙奎醚在提高療效、改善乙酰膽堿酯酶恢復(fù)時間方面均顯著優(yōu)于阿托品,且兩種用藥方案的安全性均較好。戊乙奎醚治療中、重度AOPP患者具有成本效果優(yōu)勢。
[Abstract]:Objective: to evaluate the economic efficiency of penehyclidine and atropine in the treatment of acute organophosphorus pesticide poisoning (AOPP). Methods: data of 118 patients with AOPP were collected and divided into two groups: group A (59 cases) and group B (59 cases). There were 22 mild cases, 20 moderate cases and 17 severe cases in A group, 21 mild cases, 21 moderate cases and 17 severe cases in B group. On the basis of routine therapy, patients in group A received intramuscular injection of penehyclidine hydrochloride at the initial dose of 1 mg (mild), 2 mg (moderate), and 4 mg (severe). Patients in group B received intravenous injection of atropine sulfate at the first dose of 2 mg (mild), 5 mg (moderate), and 10 mg (severe). The clinical efficacy, acetylcholinesterase recovery time and adverse reaction were observed. Cost-effect analysis was used to evaluate the economics of two groups of patients with mild, moderate and severe drug use. Results: there was no significant difference in total effective rate and acetylcholinesterase recovery time between the two groups (P0.05 in). A group, the total effective rate in severe poisoning group was significantly higher than that in B group). The recovery time of acetylcholinesterase was significantly shorter than that of group B (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Cost-effect ratio of penehyclidine and atropine was similar in mild poisoning patients, while that in moderate and severe poisoning patients was significantly lower than that in atropine patients. The results of sensitivity analysis were consistent. Conclusion: on the basis of routine treatment, the curative effect of penehyclidine and atropine on mild AOPP patients is equal, and the recovery time of acetylcholinesterase is the same. Improving the recovery time of acetylcholinesterase was better than atropine, and the safety of the two drugs was better. Patients with severe AOPP have the advantage of cost effectiveness in the treatment of pentehyclidine.
【作者單位】： 重慶市忠縣人民醫(yī)院;
【基金】：重慶市衛(wèi)生和計劃生育委員會醫(yī)學(xué)科研計劃項目(No.2015ZBXM077)
【分類號】：R595.4

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