摘要阿托品是对抗重症急性有机磷中毒(AOPP)致M样症状的有效药物,能缓解支气管痉挛,抑制腺体分泌,防治肺水肿;在抢救重症AOPP患者时,阿托品用量不足则难以有效发挥对乙酰胆碱的阻滞作用;而使用过量则易导致阿托品中毒。重症AOPP患者病情好转在停药过程中又常常出现阿托品撤药反应。国内外医务工作者对阿托品在重症AOPP救治中的使用开展了大量的研究工作,提出阿托品化的个体化判断和阿托品优化治疗,包括病程最初的冲击给药、针对肺水肿和预防阿托品中毒的维持给药、减量与停药。对近年相关研究进行简要综述,以供临床参考。
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abstractsAtropine has been an effective drug antagonizing M-like symptoms induced by severe acute organophosphate pesticide poisoning (AOPP), which could relieve bronchospasm, inhibit glandular secretion, and prevent pulmonary edema. In the rescue of severe AOPP, a hypo-dose of atropine is difficult to effectively block the effect of acetylcholine, and overdose plays great risk of atropine poisoning. When the patient's condition improves, the rebound often occurs in the process of withdrawal. Medical workers at home and abroad have conducted a lot of study to explore the personalized judgment of atropinization and optimal treatment of atropine for severe AOPP, including the initial bolus of atropine,the sustained infusion for the treatment of pulmonary edema, the maintenance dose, extenuation and withdrawal of atropine for the prevention of its overdose. Related researches in recent years were reviewed to provide the clinical reference.
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