Objective To compare the clinical effect on organophosphorus pesticide poisoning between penehyclidine hydrochloride injection and atropine. Methods From 2013 to 2015,a total of 80 patients with organophosphorus pesticide poisoning were selected in the People's Hospital of Yangshan County,Qingyuan,and they were randomly divided into control group and observation group,each of 40 cases. Based on treatment of pralidoxime chloride,patients of control group were given extra atropine, while patients of observation group were given extra penehyclidine hydrochloride injection; both groups continuously treated for 1 week. Recovery time of cholinesterase activity and autonomous consciousness, hospital stays, disappearance time of clinical symptoms( including nicotinic symptoms,muscarinic symptoms and central nervous system symptoms),incidence of adverse reactions( including tachycardia,blurring of vision,drug poisoning coma,uroschesis, bounced phenomena,delayed neuropathy and intermediate syndrome),situation of medication( including medicine dose and frequency of administration),index of myocardial enzymes(including LDH,HBDH,CK,CK-MB and AST)before and after treatment were compared between the two groups. Results Recovery time of cholinesterase activity and autonomous consciousness,hospital stays,disappearance time of nicotinic symptoms,muscarinic symptoms and central nervous system symptoms of observation group were statistically significantly shorter than those of control group(P ﹤ 0. 05). The incidence of tachycardia,blurring of vision,drug poisoning coma,uroschesis and bounced phenomena of observation group was statistically significantly lower than that of control group,respectively(P ﹤ 0. 05),while no statistically significant differences of incidence of delayed neuropathy or intermediate syndrome was found between the two groups(P ﹥ 0. 05). The medicine dose of observation group was statistically significantly less than that of control group,meanwhile the frequency of administration of observation group was statistically significantly lower than that of control group( P ﹤ 0. 05). No statistically significant differences of LDH, HBDH,CK,CK-MB or AST was found between the two groups before treatment( P ﹥ 0. 05),while LDH,HBDH,CK, CK-MB and AST of observation group were statistically significantly lower than those of control group after treatment(P ﹤ 0. 05). Conclusion Penehyclidine hydrochloride injection has better clinical effect in treating organophosphorus pesticide poisoning than atropine,can effectively shorten the recovery time of cholinesterase activity and autonomous consciousness,hospital stays and disappearance time of clinical symptoms,reduce the medicine dose and lower the frequency of administration,with less adverse reactions.%目的：比较盐酸戊乙奎醚注射液与阿托品治疗有机磷农药中毒的临床疗效。方法选取2013—2015年阳山县人民医院收治的有机磷农药中毒患者80例，随机分为对照组与观察组，每组40例。两组患者均予以氯解磷定治疗，对照组患者同时予以阿托品治疗，观察组患者同时予以盐酸戊乙奎醚注射液治疗；两组患者均连续治疗1周。比较两组患者胆碱酯酶活性恢复时间、自主意识恢复时间、住院时间、临床症状〔烟碱样（N 样）症状、毒蕈碱样（M 样）症状、中枢神经系统（CNS）症状〕消失时间、不良反应（心动过速、视力模糊、药物中毒昏迷、尿潴留、反跳现象、迟发性神经病、中间综合征）发生情况、用药情况（用药剂量、用药频率）、治疗前后心肌酶谱指标〔乳酸脱氢酶（LDH）、羟丁酸脱氢酶（ HBDH）、肌酸激酶（ CK）、肌酸激酶同工酶（ CK-MB）、天冬氨酸氨基转移酶（AST）〕。结果观察组患者胆碱酯酶活性恢复时间、自主意识恢复时间、住院时间、N 样症状消失时间、M 样症状消失时间、CNS 症状消失时间短于对照组（P ﹤0.05）。观察组患者心动过速、视力模糊、药物中毒昏迷、尿潴留、反跳现象发生率均低于对照组（P ﹤0.05）；两组患者迟发性神经病、中间综合征发生率比较，差异无统计学意义（ P ﹥0.05）。观察组患者用药剂量少于对照组，用药频率低于对照组（ P ﹤0.05）。治疗前两组患者 LDH、HBDH、CK、CK-MB、AST 水平比较，差异无统计学意义（P ﹥0.05）；治疗后观察组患者 LDH、HBDH、CK、CK-MB、AST 水平低于对照组（P ﹤0.05）。结论盐酸戊乙奎醚注射液治疗有机磷农药中毒的临床疗效优于阿托品，可有效地缩短患者胆碱酯酶活性恢复时间、意识恢复时间、住院时间和临床症状消失时间，减少患者用药剂量及用药频率，且不良反应较少。
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