敌敌畏接触中毒误诊为“憋气待查——心衰?”的原因分析

Analysis of cause for dichlorvos poisoning with skin contact misdiagnosed as “suffocation to be checked,heart failure?”

敌敌畏可通过吸入、食入及经皮吸收。进入消化、循环及神经系统后,即可导致严重的中毒症状,还可致重度中毒者心脏、肾脏、肝脏等器官系统功能的全面破坏。如抢救不及时可危及生命。一般有明确口服敌敌畏病史患者,能得到及时有效救治,而经吸入及皮肤接触的患者,往往因患者不主动提供明确病史或医生缺乏专业知识而延误诊治。现就我院收治1例敌敌畏接触中毒,被误诊为＂憋气待查,心衰？＂的病历资料回顾如下。

Dichlorvos is a common organophosphorus pesticide.Dichlorvos poisoning with skin contact is hidden.The patient had coronary heart disease medical history,six years after cardiac stenting.He had a history of skin contact with dichlorvos and nausea,vomiting,abdominal pain,diarrhea,chest tightness,suffocation symptoms,then go to a cardiac specialist hospital,diagnosis of suffocation,heart failure？After the body where contact with dichlorvos gradually show erythema spot size and blisters,then doubt is pesticide poisoning and further treatment in our hospital.To be detected trimethyl phosphate,cholinesterase was significantly lower than normal,the report is as follows.