急性有机溶剂中毒病因及发病特点分析

The rescue modalities and etiology of acute organic solvent poisoning

目的 分析急性有机溶剂中毒的病因及发病特点,探讨中毒的急救治疗措施,提高临床应急救援能力.方法 通过对776例急性有机溶剂中毒患者进行回顾性分析,分析急性有机溶剂中毒的种类、接触途径及中毒救治状况.结果 因职业性接触致急性有机溶剂中毒占87.4％,生活性中毒占12.6％.患者所接触的有机溶剂种类繁多,涉及10大类55种,居于前3位的分别为卤代烃类（24.4％）,其中卤代烷烃类占16.2％,卤代烯烃类占8.0％；芳香烃类占19.8％;氨基及硝基烃类化合物占18.3％.群体性中毒事故频发,尤以急性卤代烃类混合中毒为著.结论 急性有机溶剂中毒涉及品种多,范围广,并应注意多种有机溶剂混合中毒,尤其是卤代烃混合中毒；治疗应注意加强院前急救、急诊处理及住院治疗的连接,加强血浆置换在重度中毒中的早期应用；群体性中毒事故要注意防治心因性反应.

Objective To investigate the rescue modalities and etiology of acute organic solvent poisoning.Methods A total of 776 cases of acute organic solvent poisoning were analyzed retrospectively.The kinds of organic solvents,the modes of exposure,the characteristics of poisoning and the methods of treatment were analyzed.Results Poisoning was due to occupational exposure to organic solvents in 87.4%,the other was exposed in daily life.The total number of organic solvents harming the patients was 55.The most common three of the organic solvent poisoning were halogenated hydrocarbons poisoning,hydrocarbons poisoning,amino- and nitro-hydrocarbons poisoning.The accidents of mass poisoning were increasing in numbers recently,especially the acute halogenated hydrocarbons poisoning.Conclusion To know the numerous poisonings responsible for acute solvent poisoning is essential for enhancing the pre-hospital care,emergency treatment and following treatment.Also,extensive clinical knowledge and numerous biologic laboratory tests are needed to improve the diagnosis and rescue of acute solving poisoning.Effect of therapeutic plasma exchange treatment on sever acute poisoning is with a positive attitude.