急性有机磷农药中毒致“中间型综合征”4例报告及文献复习

The intermediate syndrome in organophosphorus pesticides poisoning: a report of 4 cases

报道了急性有机磷农药（ＯＰ）中毒引起的中间型综合征（ＩＭＳ） ４例。主要表现为ＯＰ中毒后经足量阿托品、胆碱酯酶重活化剂治疗后，其急性胆碱能危象消失，此后突发呼吸肌麻痹，抢救无效死亡。通过文献复习，综述了ＩＭＳ的诊断、鉴别诊断及其救治现状。人工呼吸机维持呼吸功能是其主要的治疗措施。

The intermediate syndrome(IMS) of organophosphorus poisoning, occurring in the interval between the acute cholinergic crisis and the onset of delayed neuropathy was firstly reported in 1987. Four cases died of the IMS reported in this paper had signs of IMS after the disappearance of the acute cholinergic crisis following atropine and AChE reactivator treatment. The patients suddenly suffered from acute respiratory paralysis without other causes. The diagnosis and the differential diagnosis of IMS are discussed with a review of literature. The artificial ventilation is the primary method of treatment.