背景:有机磷中毒(OPP)是许多地区的重大健康问题,尤其是在发展中国家。尽管与暴露相关的复杂性和死亡人数不断增加,治疗方法多年来一直保持不变。根据临床见解,某些药物已被证明可提高结局并减少此类暴露引起的并发症.
目的:本研究的目的是比较N-乙酰半胱氨酸治疗急性有机磷中毒的疗效。就a)其对阿托品需求的影响而言,b)住院时间,和死亡率。
方法:该研究在拉合尔总医院的重症监护病房(ICU)进行。30例具有急性有机磷中毒病史和临床表现的患者以1:1的比例随机分为两组。治疗组给予阿托品肠胃外给药,普拉多肟,和N-乙酰半胱氨酸(NAC)作为佐剂,对照组接受急性有机磷(OP)毒性的标准治疗。
结果:在整个研究期间,30例急性有机磷(OP)毒性患者(14例男性,16名妇女)接受了检查,平均年龄(25.83±11.59)岁。在介入组中,只有四名患者需要入住ICU,但在对照组中,8例患者入住ICU.阿托品剂量与住院时间之间的相关性结果在两个研究组之间无统计学意义(<0.005)。血浆胆碱酯酶(PChE)水平(KUL-1)和缓立肟总剂量(g)在住院时间上有统计学意义。数据不是正态分布的,因此应用了非参数检验。Wilcoxon排名测试显示在控制组和干预组中都有显着改善,因为p值为(<0.005)。通过使用Mann-WhitneyU检验分析的组间比较显示,干预组的严重程度和其他相关症状显着降低,因为p值为(0.001)。
结论:结果表明,NAC组对阿托品的需求减少,而不是对缓立肟的需求减少。在NAC组中,住院时间和死亡率降低.建议在本研究程序中使用NAC治疗急性有机磷(OP)中毒。
BACKGROUND: Organophosphorus poisoning (OPP) stands as a significant health concern in numerous regions, especially in developing nations. Despite the rising complexities and case fatalities associated with exposure, the treatment approach has remained unchanged for many years. Based on clinical insights, certain pharmacologic agents have demonstrated utility in enhancing outcomes and reducing complications arising from this type of exposure.
OBJECTIVE: The objective of this study is to compare the outcome of N-acetyl cysteine in the treatment of acute organophosphate poisoning cases. In terms of a) its impact on the requirement of atropine, b) Length of hospital stay, and mortality.
METHODS: The study was conducted in the intensive care unit (ICU) of the General Hospital Lahore. Thirty patients with a history and clinical presentation indicative of acute organophosphorus poisoning were randomly divided into two groups in a 1:1 ratio. The treatment group received parenteral administration of atropine,
pralidoxime, and N-acetylcysteine (NAC) as an adjuvant, and the control group received standard treatment for acute organophosphate (OP) toxicity.
RESULTS: Throughout the study duration, 30 patients suffering acute organophosphate (OP) toxicity (14 men, 16 women) were examined, with an age mean of (25.83±11.59) years. In the interventional group, only four patients required ICU admission, but in the control group, eight patients were admitted to ICU. The correlation result between the dose of atropine and length of hospital stays was not statistically significant between both study groups (<0.005). Plasma Cholinesterase (PChE) level (KU L-1) and total dose of
Pralidoxime (g) were statistically significant in the length of hospital stay. The data was not normally distributed, so the non-parametric tests were applied. The Wilcoxon ranked test showed significant improvement in both the controlled and interventional groups because the p-value was (<0.005). Intergroup comparison analyzed by using the Mann-Whitney U test showed a significant reduction in the severity and other associated symptoms in the interventional group because the p-value was (0.001).
CONCLUSIONS: The outcome demonstrated that the NAC group had a decreased demand for atropine rather than
Pralidoxime. In the NAC group, the length of hospital stay and mortality was decreased. The administration of NAC to the present study procedure for acute organophosphate (OP) poisoning is suggested.