急性有机磷中毒者临床结局2年后的随访调查

Two-year follow-up study on clinical outcomes of non-occupational pesticides poisoning

目的 探讨急性有机磷农药中毒 (AOPP)患者的远期临床结局。方法 对 132例口服有机磷中毒者进行急性中毒 2年后的随访调查。结果 (1) 12例失访 ,其中 1例因出现有机磷迟发性神经病 (OPIDP)再服有机磷农药自杀死亡 ,失访率为 9.0 9%。 (2 ) 11例于急性中毒后 2～ 8周出现OPIDP ,仅 5例赴医院诊治 ,1例于 6个月后完全恢复 ,其余未经医院治疗亦都有不同程度的好转。中毒后 1年内OPIDP发生率为 9 17% ,2年后为 6 6 7%。 (3)急性中毒时有 38例同时诊断有精神病 ,其中枢神经与精神症状的发生率于 2年后比较无明显变化。 82例非精神病者在急性中毒时出现的中枢神经与精神症状中 ,除头痛、头晕等于中毒 2年后恢复较好外 ,其余如睡眠障碍、记忆障碍、情绪低落和急躁易怒等症状均无明显改变。结论 大多数急性有机磷农药中毒者临床结局较好 ,遗留迟发性神经病的后遗症者不足 10 % ,少数患者可能遗留中枢神经与精神症状。中毒者恢复情况可能与救治情况有关 。

Objective To investigate the neurological and psychiatric clinical outcomes of acute organophosphate insecticides (OPs) poisoning.Methods A two-year follow-up study was performed in 132 OPs poisoning patients with non-occupational exposure.Results (1)The prevalence of organophosphate induced delayed polyneuropathy (OPIDP)was 9.17%.Most of the OPIDP cases recovered gradually.Five of them were treated in the hospital and only one patient recovered entirely.Another patient ingested insecticides again and died.(2)The psychiatric symptoms of 38 cases who were diagnosed as psychiatric diseases during acute OPs poisoning remained unchanged.Several neurological and psychiatric symptoms in the rest patients were alleviated significantly.However,the frequency of insomnia,amnesia,depression and imitability was still higher than that before acute poisoning.Conclusion The outcomes of most patients of acute OPs poisoning were favorable.9.17% of the patients developed OPIDP.The psychiatric symptoms remained unchanged in patients complicated with psychiatric disorders.The central nervous system manifestations recovered significantly in the rest of patients except few neurotic symptoms.