戊乙奎醚与阿托品治疗急性有机磷中毒的药物经济学分析

发布时间：2018-12-15 08:12

【摘要】：目的:评价戊乙奎醚与阿托品治疗急性有机磷农药中毒(AOPP)的经济性。方法:收集118例AOPP患者资料,按治疗方案的不同分为A组(59例)和B组(59例),其中A组轻度22例、中度20例、重度17例;B组轻度21例、中度21例、重度17例。在常规治疗的基础上,A组患者肌内注射盐酸戊乙奎醚注射液首次剂量1 mg(轻度)、2 mg(中度)、4 mg(重度),B组患者静脉注射硫酸阿托品注射液首次剂量2 mg(轻度)、5 mg(中度)、10 mg(重度),两组均视情况给予维持治疗待症状消失后停药。观察两组患者的临床疗效,乙酰胆碱酯酶恢复时间及不良反应发生情况。采用成本-效果分析方法评定两组轻、中、重度患者用药方案的经济性。结果:两组轻度中毒患者总有效率、乙酰胆碱酯酶恢复时间比较,差异均无统计学意义(P0.05)。A组中、重度中毒患者总有效率均显著高于B组,乙酰胆碱酯酶恢复时间均显著短于B组,差异均有统计学意义(P0.05)。两组轻、中、重度患者不良反应发生率比较,差异均无统计学意义(P0.05)。轻度中毒患者,戊乙奎醚与阿托品的成本-效果比相当;中、重度中毒患者,戊乙奎醚的成本-效果比均显著低于阿托品。敏感度分析结果与一致。结论:在常规治疗的基础上,戊乙奎醚与阿托品治疗轻度AOPP患者的疗效、乙酰胆碱酯酶恢复时间均相当,对于中、重度AOPP患者戊乙奎醚在提高疗效、改善乙酰胆碱酯酶恢复时间方面均显著优于阿托品,且两种用药方案的安全性均较好。戊乙奎醚治疗中、重度AOPP患者具有成本效果优势。
[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.
【作者单位】：重庆市忠县人民医院;
【基金】：重庆市卫生和计划生育委员会医学科研计划项目(No.2015ZBXM077)
【分类号】：R595.4

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