大剂量氨溴索联合甲泼尼龙治疗百草枯中毒的临床观察

大剂量氨溴索联合甲强龙早期应用对百草枯中毒肺纤维化的疗效田雷;周殊;程景林【摘要】Objective To study the effects of high-dose ambroxol combined with methylprednisolone on pulmonary fibrosis in patients with early curative effect of paraquat poisoning.Methods Ninety-eight cases of paraquat poisoning patients admitted to the Second Affiliated Hospitalwere selected and randomly divided into two groups according to the date of admission,namely,a strong dragon group alone (control group) and ambroxol combined with a strong dragon group (observation group),with 49 patients in each group,then the survival rate,the incidence of pulmonary fibrosis and the degree of pulmonary fibrosis in the two groupswere observed.Results The survival rate of the observation group and the control group at each time point was not statistically significant,andthe incidence of pulmonary fibrosis in the observation group and the control group on the third daywas not statistically significant.In the fourth week,the incidence rate of pulmonary fibrosis in the observation group was significantly lower than that in the control group (P ＜ 0.05).In the observation group,the degree of pulmonary fibrosis increased in the first week compared to that of the third day (P ＜0.05).The degree of pulmonary fibrosis in the control group was increased at each time point compared with the previous time (P ＜ 0.05).The degree of pulmonary fibrosis in the observation group was lower than that in thecontrol group in the secondand fourth week(P ＜ 0.05).Conclusion The survival rate of patients is not significantly increased by the application of large dose of ambroxol hydrochloride combined with methylprednisolone in early stage of paraquat poisoning,but the occurrence rate and the degree of pulmonary fibrosis resulted from paraquat poisoning is decreased,thus it can be used for clinicaltreatment.%目的研究大剂量氨溴索联合甲强龙早期应用对百草枯中毒患者肺纤维化的疗效.方法选取安徽医科大学第二附属医院98例百草枯中毒患者,按入院日期随机分成甲强龙组(对照组)及氨溴索联合甲强龙组(观察组),每组49例,观察两组患者的存活率、肺纤维化发生率和肺纤维化程度.结果观察组和对照组在各时间点的存活率差异无统计学意义(P＞0.05),观察组与对照组在第3天的肺纤维化发生率差异无统计学意义(P＞0.05),第4周时,观察组肺纤维化发生率显著低于对照组(P＜0.05),观察组在第1周比第3天的肺纤维化程度增加(P＜0.05),而对照组各时间点比前一时间点的肺纤维化程度增加(P＜0.05),在第2周及第4周时,观察组肺纤维化程度低于对照组(P＜0.05).结论大剂量氨溴索联合甲强龙早期应用对百草枯中毒患者的存活率不能显著提高,但使百草枯中毒导致的肺纤维化发生率及肺纤维化程度均有所下降,可用于临床.【期刊名称】《安徽医学》【年(卷),期】2016(037)012【总页数】3页(P1522-1524)【关键词】百草枯中毒;氨溴索;甲强龙;存活率;肺纤维化【作者】田雷;周殊;程景林【作者单位】230601 合肥安徽医科大学第二附属医院急诊内科;230601 合肥安徽医科大学第二附属医院急诊内科;230601 合肥安徽医科大学第二附属医院急诊内科【正文语种】中文百草枯系有机杂环类接触性除草剂，在农业生产中的使用是仅次于有机磷类的第二大农药。

大剂量盐酸氨溴索治疗急性百草枯中毒肺损伤的临床研究王煜;刘振宁;赵敏【期刊名称】《实用药物与临床》【年(卷),期】2015(000)007【摘要】Objective To observe the effect of high dose ambroxol hydrochloride in the treatment of pulmona-ry damage in acute paraquat poisoning. Methods Forty patients of acute paraquat poisoning with pulmonary damage were randomly divided into 2 groups: control group ( n=20 ) and treatment group ( n=20 ) . Control group received conventional therapy,and the treatment group was added with intravenous infusion of ambroxol hydrochloride 20 mg/(kg·d) q12h for 5 d. The artery blood gas,HRCT film changes,the number of cases with multiple organ dysfunction syndrome ( MODS) ,mortality,and survival time of the death cases were observed. Serum MDA,SOD and TNF-α,IL-6 levels were measured in 2 groups before treatment and at 5 d after treatment. Results After treatment,the oxygen partial pressure, oxygenation index, and HRCT film changes were all improved in the 2 groups ( P<0. 01 or P <0. 05),there was significant difference between the two groups (P<0. 05). The number of MODS cases in treatment group were lower than those in control group (P<0. 05),but no significant difference was found in mortality between the two group (P>0. 05). After treatment,plasma level of MDA all decreased in the 2 groups,there was significant difference between the two groups ( P<0. 05 ); plasma level of SOD all rose in the 2 groups, there was significant difference between the two groups ( P <0. 05 ) . After treatment, plasma level of TNF-α, IL-6 all decreased in the 2 groups,there was significant difference between the two groups (P<0. 05). Conclusion High dose ambroxol can be adopted to improve the ability of anti-oxidantion of the organism,inhibit lipid peroxidation and the levels of proinflam-matory factor,lessen pulmonary damage,thus it has a certain therapeutic effect for treatment of acute paraquat poison-ing.%目的：观察大剂量盐酸氨溴索治疗急性百草枯( PQ)中毒肺损伤的临床效果。

大剂量环磷酰胺与甲强龙联合无创正压通气治疗百草枯中毒的临床研究胡玉峰;汪红友;李君;刘宝【期刊名称】《中国医药指南》【年(卷),期】2013(11)18【摘要】目的探讨大剂量环磷酰胺、甲强龙联合无创正压通气治疗百草枯中毒的疗效。

方法选择2009年10月至2010年11月百草枯中毒患者21例试验，其中男性8例，女性13例，平均年龄（39.6±15.6）岁。

对照组：采用回顾性匹配的方法，选择2009年1月至2009年9月的21例百草枯中毒患者。

其中男11例，女10例，平均年龄（34.1±15.4）岁。

对照组常规治疗加地塞米松，治疗组常规治疗加大剂量环磷酰胺和甲强龙，并据需要联合应用无创正压通气。

比较两组患者低氧血症、急性肾损伤、中毒性肝炎的发生率、生存时间和病死率。

结果对照组肾功损害、肝损害发生率分别为76.2%和66.7%，而治疗组分别为47.6%和47.6%，无统计学差异。

对照组低氧血症发生率为95.2%较治疗组57.1%明显升高，差异有统计学意义。

治疗组生存时间较对照组延长（19.1±4.9 VS 8.6±3.5， t=-4.451，P=0.000），差异有统计学意义（P ＜0.05）。

治疗组病死率10/21（47.6%），较对照组病死率18/21（85.7%）降低（χ2=5.081， P=0.024），差异有统计学意义（P ＜0.05）。

结论大剂量环磷酰胺与甲强龙联合无创正压通气治疗百草枯中毒，能够延长患者生存时间、降低病死率。

%Objective To study curative effect of the pulse large dose of cyclophosphamide and methylprednisolone combined with non-invasion mechanic ventilation for paraquatpoisoning .Methods 21 cases with paraquat poisoning from Jan. 2009 toSept. 2009 served as control group and 21 cases from Oct. 2009 to Dec. 2010 served as trial group .Conventional therapy plus dexamethasonwas performed in the control group (21 cases), and the pulse large dose of cyclophosphamide and methylprednisolone combined with non-invasion mechanic ventilation were used in the trial group (21 cases).The rate of hypoxemia、kidney and liver injury were compared between two groups. Survival time and mortality of two groups were also compared .Results The prevalence of acute renal failure, hepatitis were 76.2% and 66.7% in control group respectively, and 47.6%, 47.6% in the trail group respectively. There were no significant differences of prevalence rate of those symptoms between the two groups. But the prevalence of hypoxemia in control group were higher than the treatment group .However, survival time in the trail group(19.1±4.9d) were longer than those in the controlgroup(8.6±3.5d, P<0.05), and mortality in trail group(47. 6%, 10/21) was lower than that of control group(85.7%, 18/21, P<0.05). Conclusion Pulse large dose of cyclophosphamide and methylprednisolone combined with non-invasion mechanic ventilation can reduce mortality and prolong survival time.【总页数】3页(P410-412)【作者】胡玉峰;汪红友;李君;刘宝【作者单位】马鞍山市人民医院急诊科，安徽马鞍山 243000;马鞍山市人民医院急诊科，安徽马鞍山 243000;马鞍山市人民医院急诊科，安徽马鞍山 243000;安徽省立医院ICU，安徽合肥 230001【正文语种】中文【中图分类】R595.4【相关文献】1.大剂量氨溴索联合甲强龙早期应用对百草枯中毒肺纤维化的疗效 [J], 田雷;周殊;程景林2.环磷酰胺联合大剂量甲泼尼龙治疗对百草枯中毒患者血清金属蛋白酶9水平的影响 [J], 徐宁;郭晋;伍德生3.环磷酰胺联合大剂量糖皮质激素治疗r百草枯中毒效果观察 [J], 陈朋4.大剂量环磷酰胺治疗百草枯中毒的临床研究 [J], 陈新宇;王兴英;张凤平;宁秋5.环磷酰胺联合大剂量糖皮质激素治疗百草枯中毒效果及对肝肾损害影响观察 [J], 劳家畅; 陈康杰; 肖仙章因版权原因，仅展示原文概要，查看原文内容请购买。

大剂量盐酸氨溴索治疗急性百草枯中毒肺损伤的临床观察高渝峰;廖晓星;李玉杰;阮惠芬【期刊名称】《中国急救复苏与灾害医学杂志》【年(卷),期】2008(003)005【摘要】目的观察大剂量盐酸氨溴索治疗急性百草枯中毒(PQ)肺损伤的疗效.方法将41例急性百草枯中毒肺损伤患者分为治疗组(21例)和对照组(20例),对照组给予大剂量甲泼尼龙、抗氧化以及血液净化等治疗,使用呼吸机通气:治疗组在对照组治疗基础上加用盐酸氨溴索注射液20 nag·kg-1·d-1静脉滴注q 12 h,3～5 d;观察两组动脉血气、呼吸参数,X线胸片变化(第1、3、5天),发生多脏器功能障碍综合征(MODS)(≥3个脏器)及多器官衰竭(MOF)病例,病死率与死亡病例存活时间.结果治疗后两组氧分压、氧合指数以及自主呼吸频率与潮气量、呼气末正压、X线胸片改变等均有改善(P<0.01),治疗组的改善与对照组比较改善更为显著(P<0.05).两组间MODS(≥3)与MOF、病死率与死亡病例存活时间差异无统计学意义(均P>0.05).结论大剂量盐酸氨溴索注射液虽未能逆转患者的整个病程,但可以显著改善动脉血气、呼吸参数,对急性PQ中毒肺损伤有积极的治疗作用.【总页数】3页(P261-263)【作者】高渝峰;廖晓星;李玉杰;阮惠芬【作者单位】510620,广东省广州市第十二人民医院,ICU;510080,广州,中山大学附属第一医院急诊科;510080,广州,中山大学附属第一医院急诊科;中山大学附属第一医院黄埔院区急诊科【正文语种】中文【中图分类】R563.8【相关文献】1.大剂量盐酸氨溴索治疗急性肺损伤的效果研究 [J], 林光建2.大剂量盐酸氨溴索治疗急性百草枯中毒肺损伤的临床研究 [J], 王煜;刘振宁;赵敏3.机械通气联合大剂量盐酸氨溴索注射液治疗小儿急性肺损伤的临床疗效研究 [J], 李群;4.机械通气联合大剂量盐酸氨溴索注射液治疗小儿急性肺损伤的临床疗效研究 [J], 李群5.大剂量盐酸氨溴索治疗肝移植术后急性肺损伤的临床观察及其对炎症介质的影响[J], 雷联会;韦中余;俞森洋;王瑜贵;程芮;杨洋;臧运金因版权原因，仅展示原文概要，查看原文内容请购买。

甲泼尼龙联合氨溴索救治烟雾弹中毒的效果观察黄国亮;范海鹏;闫红【期刊名称】《西南国防医药》【年(卷),期】2018(028)002【摘要】Objective To explore the application effect of short-term systemic glucocorticoids (GC) combined with ambroxol in the emergency treatment of poisoning from smoke grenade.Methds A total of 60 patients poisoned by smoke grenade were randomly divided into an observation group and a control group;both groups received routine emergency treatment,and on the basis of this,the control group was additionally treated with methylprednisolone via intravenous injection for three consecutive days at twice/d and 500 mg/d,and the observation group was additionally treated with ambroxol hydrochloride for three consecutive days via intravenous injection at twice/d and 60 mg/d.The success rate of treatment,the incidence of complications,the arterial blood gas indexes,the lung injury score and the inflammatory factors were compared between two groups.Results The success rate of treatment in the observation group (93.33％) was higher than that in the control group (86.67％),but there was no statistically significant difference (P ＞ 0.05);there was no significant difference in the incidence of complications between the groups (P ＞0.05);after treatment,the partial pressure of arterial oxygen (PaO2) and the oxygenation index in the observation group were significantly higher thanthose in the control group,while the levels of partial pressure of carbon dioxide (PaCO2),serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly lower than those in the control group (P ＜0.05).Conclusion The methylprednisolone combined with ambroxol shows high success rate in the treatment of poisoning from smoke grenade and can obviously improve the blood gas indexes,reduce the lung injury and inhibit inflammatory reactions.%目的探讨全身短期糖皮质激素(GC)联合氨溴索在烟雾弹中毒急诊救治中的应用效果.方法随机将60例烟雾弹中毒患者分为观察组与对照组,均接受急诊常规救治,此外对照组给予甲泼尼龙静脉注射,2次/d,500mg/d,连续应用3d;观察组在对照组基础上,给予盐酸氨溴索注射液静脉注射,2次/d,60 mg/d,连续用药3d.比较两组救治成功率、并发症发生率、动脉血气指标、肺损伤评分及炎性因子指标.结果观察组救治成功率(93.33％)虽高于对照组(86.67％),但差异无统计学意义(P＞0.05);两组并发症发生率无显著差异(P＞0.05);观察组治疗后动脉血氧分压(PaO2)、氧合指数显著高于对照组,二氧化碳分压(PaCO2)、血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均显著低于对照组(P＜0.05).结论甲泼尼龙联合氨溴索救治烟雾弹中毒成功率较高,能明显改善患者血气指标,减轻肺损伤,抑制炎症反应.【总页数】3页(P138-140)【作者】黄国亮;范海鹏;闫红【作者单位】362000福建泉州,解放军180医院急诊科;362000福建泉州,解放军180医院急诊科;362000福建泉州,解放军180医院急诊科【正文语种】中文【中图分类】R135.14/595.1【相关文献】1.大剂量氨溴索联合甲泼尼龙环磷酰胺治疗百草枯中毒的临床观察 [J], 夏敏;艾伟;孙林;陈家杰2.血液灌流联合甲泼尼龙、环磷酰胺救治百草枯中毒患者24例的临床体会 [J], 苏友丽其其格3.甲泼尼龙联合氨溴索对急性百草枯中毒家猪肺损伤的影响研究 [J], 兰超;李海娜;李莉;王金柱;李璐;刘兰萍;狄敏4.甲泼尼龙静脉推注联合氨溴索、布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的效果观察 [J], 高兴华;黄剑5.甲泼尼龙静脉推注联合氨溴索、布地奈德雾化吸入治疗慢性阻塞性肺疾病急性加重期的效果观察 [J], 高兴华;黄剑因版权原因，仅展示原文概要，查看原文内容请购买。

百草枯中毒患者采取不同剂量甲基强的松龙治疗的效果观察【摘要】百草枯是一种常见的农药中毒原因，但目前对其中毒患者的治疗研究还比较有限。

本研究旨在观察不同剂量甲基强的松龙治疗在百草枯中毒患者中的效果。

通过样本选择和分组，我们对不同剂量的甲基强的松龙进行治疗，并设定观察指标来评估疗效。

结果分析显示不同剂量的甲基强的松龙在百草枯中毒患者中具有一定的疗效，且剂量与疗效呈正相关关系。

甲基强的松龙治疗在百草枯中毒患者中具有潜在的应用前景，但研究局限性在于样本量较小及研究设计的单一性。

未来可以进一步扩大样本量，深入研究甲基强的松龙治疗在百草枯中毒患者中的作用机制及优化治疗方案。

【关键词】百草枯中毒、甲基强的松龙、剂量、疗效、观察、样本选择、结果分析、治疗过程、研究背景、研究目的、应用前景、研究局限性、未来展望。

1. 引言1.1 研究背景百草枯是一种常见的除草剂，但是如果被误服或接触，容易引起中毒反应，对人体健康造成严重威胁。

目前，百草枯中毒患者的治疗方法主要包括洗胃、解毒药物等，但是对于重症患者，传统治疗方法效果不明显，容易出现并发症和死亡情况。

甲基强的松龙是一种广泛应用于临床的糖皮质激素类药物，具有抗炎、抗过敏、抗毒等作用，被广泛用于各种中毒患者的治疗。

有研究表明，甲基强的松龙在治疗中毒患者时具有一定的疗效，能够减轻症状、改善患者的生命体征。

目前对于百草枯中毒患者采取不同剂量甲基强的松龙治疗的效果尚未有系统研究和报道。

本研究旨在观察不同剂量甲基强的松龙治疗对百草枯中毒患者的影响，为临床治疗提供更为科学的依据和指导。

1.2 研究目的略少或者过多，请适当调整。

本研究旨在探讨不同剂量甲基强的松龙治疗对百草枯中毒患者的影响，评估其疗效和安全性。

通过比较不同剂量甲基强的松龙治疗在百草枯中毒患者中的疗效差异，进一步探讨最佳治疗方案，为临床治疗提供科学依据。

我们希望通过本研究，可以更全面地了解甲基强的松龙在治疗百草枯中毒患者中的作用机制及效果，为临床医生提供更准确的治疗方案，提高患者的治疗效果和生存率。