急性有机磷农药中毒抢救体会

The Rescuing Experience of Acute Organophosphorus Pesticide Poisoning

目的:探讨急性有机磷类农药中毒(AOPP)的病理生理特点和治疗方案,提高AOPP的救护水平。方法:回顾性分析44例AOPP的诊治经过,调查了胃肠道清洗、规范使用阿托品和复能剂、动态检测胆碱酯酶、监护重要器官功能、辅助呼吸和血液透析治疗的价值。结果:胆碱酯酶的活性和中毒程度相关,44例患者中,治愈39例,死亡5例。结论:胃肠道清洗是可阻断有机磷继续进入体内,合理使用阿托品和复能剂以及严格掌握减量时机是关键步骤,辅助呼吸和血液透析是抢救重度中毒者的必要手段,动态检测胆碱酯酶的活性可减少IMS的死亡率。

Objective： To explore the characteristic of pathophysiology and therapeutic regimen of acute organophosphorus pesticide（AOPP） in order to improve the rescuing ability. Methods： There were 44 cases of AOPP whose data was analysed retrospectively, The appraisal was given about the value of gastrointestinal tract ablution, usage of atropine and reactivation agent, dynamic surveillance of acetylcholine esterase, the mainteinance of vital organ, assisted respiration and hematodialysis. Results： The severity of poisoning correlated with activity of acetylchohne esterase. In forty-four cases, thirty-nine cases recovered through positive rescue, and five died. Conclusion： It is beneficial of gastrointestinal tract ablution to block up absorption, rational use and regulate decrement of atropine and reactivation agent to reject toxicity, assisted respiration and hematodialysis to rescue the most serious cases, dynamic surveillance of acetylcholine esterase to reduce risk of IMS.