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[目的]观察参麦注射液救治急性乌头碱中毒疗效。[方法]使用随机平行对照方法,将43例门诊及住院患者按随机数字表法分为两组。对照组22例收诊之后进行催吐、洗胃,使用硫酸镁溶液进行导泻等基础治疗,呼吸衰竭及困难患者进行吸氧操作。所有患者入院即进行心电监护,24h内每隔3h复查心电7图。频发室性期前收缩、室性心律失常、室性期前收缩二联律或三联律、多源多形性室性心律失常者利多卡因,0.05~0.1g/次,1次/d,静注。若无效则改用普罗帕酮,100~200mg/次,3~4次/d,口服。或胺碘酮,0.6g/次,1次/d。合并呼吸衰竭、意识不清者纳络酮,5μg/kg,待15min后再肌注10μg/kg,3次/7d,静滴。休克给予180~200mg多巴胺,先5(μg/㎏)/分滴注,然后以5~10(μg/㎏)/分递增至20~50(μg/㎏)/分+500mL生理盐水,静滴。利多卡因0.05mg/次,1次/d,静注,180mg利多卡因+500mL生理盐水,静滴。治疗组21例在在中毒救治的起始阶段采用40~60mL参麦注射液+5%~50%葡萄糖注射液,静滴。西药治疗同对照组。两组均连续治疗30d为1疗程。观测临床症状、心电图、不良反应。治疗1疗程,判定疗效。对40例患者随访30d,检测心率,心电图指标。[结果]治疗组痊愈14例,改善6例,无效1例,总有效率96.24%。对照组痊愈8例,改善9例,无效5例,总有效率77.27%。治疗组疗效优于对照组(P<0.05)。心电图改善治疗组优于对照组(P<0.05)。随访41例患者30d,检测24h动态心电图,心率变化,血压等,疗效判定时结果变化,痊愈病例稳定无复发。[结论]参麦注射液救治急性乌头碱中毒效果显著,值得推广。
[Objective] To observe the curative effect of Shenmai injection on acute aconitine poisoning. [Methods] Using randomized parallel control method, 43 outpatients and inpatients were divided into two groups according to random number table. Twenty-two patients in the control group received vomiting, gastric lavage, and basic treatment such as catharsis, using magnesium sulfate solution. Patients with respiratory failure and difficulty in oxygen inhalation operation. All patients admitted to the hospital for ECG, ECG examination every 3h within 24h Figure 7. Frequent ventricular premature contractions, ventricular arrhythmias, ventricular premature contractions double or triple law, multi-source polymorphic ventricular arrhythmias, lidocaine, 0.05 ~ 0.1g / time, 1 / d , Intravenous injection. If not use propafenone instead, 100 ~ 200mg / time, 3 ~ 4 times / d, orally. Or amiodarone, 0.6g / time, 1 time / d. Respiratory failure, unconscious naloxone, 5μg / kg, to be 15min and then intramuscular injection of 10μg / kg, 3 times / 7d, intravenous infusion. Shock given 180 ~ 200mg dopamine, first 5 (g / ㎏) / min infusion, and then 5 ~ 10 (g / ㎏) / min and increased to 20 ~ 50 . Lidocaine 0.05mg / time, 1 / d, intravenous injection, 180mg lidocaine + 500mL saline, intravenous infusion. 21 cases of treatment group in the initial stage of treatment of poisoning using 40 ~ 60mL Shenmai injection + 5% ~ 50% glucose injection, intravenous infusion. Western medicine treatment with the control group. Continuous treatment of both groups 30d for a course of treatment. Observation of clinical symptoms, ECG, adverse reactions. Treatment of a course of treatment to determine the efficacy. Forty patients were followed up for 30 days to detect heart rate and ECG. [Results] The treatment group cured 14 cases, 6 cases improved, 1 case ineffective, the total effective rate was 96.24%. The control group recovered in 8 cases, improved in 9 cases, 5 cases, the total effective rate was 77.27%. The treatment group was better than the control group (P <0.05). ECG improved treatment group than the control group (P <0.05). After 41 days of follow-up, the electrocardiogram, heart rate change and blood pressure were measured at 30 days. The results of the changes were determined when the curative effect was determined. No recurrence was found in the cured cases. [Conclusion] Shenmai injection is effective in treating acute aconitine poisoning and is worth promoting.