急性有机磷中毒中间综合征17例临床分析

Clinical analysis of 17 cases of intermediate syndrome after acute organophosphorus pesticides poisoning

目的 探讨急性有机磷农药中毒并发中间综合征 (intermediatesyndrome ,IMS)的诊断与治疗。方法 回顾性分析 17例IMS患者的临床表现。结果 有机磷农药中毒并发IMS的患病率为2 .8% ;其呼吸肌麻痹症状出现在急性中毒后 10～ 72h ,9例于 5～ 12min内成功建立人工气道及机械通气 ,其中 7例治愈 ,另 8例因各种原因未及时应用该疗法而死亡。结论 IMS并非罕见 ,临床表现有特殊性 ,应提高认识 ,早期识别 ;建立人工气道与机械通气是抢救的重要方法。

Objective To investigate the diagnosis and treatment of intermediate syndrome(IMS) after acute organophosphorus pesticides poisoning(AOPP).Methods 17 patients with IMS after AOPP were retrospectively analyzed.Results The occurrence of IMS was 2.8% in total 612 patients with AOPP.The majority of IMS cases were of severe oral AOPP.The respiratory muscle paralysis(RMP) was the most important sign for the diagnosis ,which appeared at 10～72 h after poisoning.9 patients were treated by means of urgent tracheal intubation and mechanical ventilation in 5～12 min,7 of them were cured;The other 8 patients died because of delayed treatment.Conclusion IMS is not a uncommon syndrome.There are some special clinical features such as RMP,which should be identified early.Urgent tracheal intubation and mechanical ventilation are important measures.