To investigate the clinical efficacy of penehyclidine hydrochloride and atropine in treatment of acute organophosphorus pesticide poisoning (AOPP) so as to provide theoretical foundation for optimal treatment program of AOPP.

A retrospective study was done on the clinical data of patients with severe AOPP. The patients were divided into penehyclidine hydrochloride group and atropine group. The clinical efficacy was observed. The times of administration, time to atropinization, incidence of complications, time of recovery of cholinesterase (ChE) activity to 70%, hospitalization time and cost, cure rate and mortality rate in two groups were observed and analyzed.

In atropine group, the cure rate was 92.47% (221/239), the mortality rate was 3.77% (9/239) and the incidence of complications was 27.20% (65/239). In penehyclidine hydrochloride group, the cure rate was 96.59% (283/293), the mortality rate was 1.02% (3/293) and the incidence of complications was 6.48% (19/293). Compared with atropine group, penehyclidine hydrochloride group had a high cure rate (χ² = 4.477, P=0.034), a low death rate (χ² =4.489, P=0.034), and a low incidence of complications (χ²=42.468, P=0.000). Furthermore, penehyclidine hydrochloride group had reduced times of administration, shortened time to atropinization, rapid recovery of ChE activity, short hospital stay, and low hospital expenses. The differences between two groups were statistically significant (P<0.05).

Penehyclidine hydrochloride can yield quick symptomatic remission, fewer complications and lower morbidity in the treatment of AOPP, with better clinical efficacy than atropine.