有机磷中毒迟发性神经损害35例随访研究

Follow-up studies on delayed nervous lesion caused by organophosphorous poisoning in thirty five cases of patients

目的研究有机磷农药中毒迟发性神经病(OPIDN)的治疗和预后。方法对OPIDN患者给予能量合剂、胞苷三磷酸(CTP)治疗,改善能量供应,给予活血药物改善循环,给予神经营养剂治疗,肌张力增高患者加服降肌张力药。随访1～4年。结果在30例周围性神经损害患者中,29例恢复良好,1例四肢肌肉中度萎缩,生活不能自理。5例中枢性神经损害患者,均遗留肢体肌张力增高,活动笨拙,智力轻度减退;1例年轻女性伴内分泌功能障碍,断经、不孕4年。5例均能生活自理。结论及时纠正缺氧、改善血液循环是早期防治的关键,能量合剂、胞苷三磷酸配合活血和营养神经药物对OPIDN的治疗有效。

Objective To study the therapy and prognosis in the patients with organophosphate induced delayed neuropathy（OPIDN） caused by organophosphorous poisoning.Methods The patients with OPIDN were treated with energy mixture,cytidine triphosphate（CTP） to improve energy provision,blood-activating drugs to improve blood circulation,and neurotrophic drugs.The patients with hypermyotonia were treated with drugs of reducing the muscular tension.All patients were followed up for one to four years.Results Among 30 cases of patients with peripheral nerve lesion,29 cases were recovered well;1 case with moderate atrophy of limbs muscle couldn＇t take care of himself;all of 5 cases with central nervous damage had muscular tension increasing,moves clumsily and intelligence decreasing slightly;one young woman with endocrine disorders suffered cessation,barrenness for four years;all of 5 cases could take care of themselves.Conclusion Correcting hypoxia in time and improving blood circulation is the key point for early prevention and cure.The treatment of energy mixture,cytidine triphosphate combined with blood-activating and neurotrophic drugs are effective to the patients with OPIDN.