重症有机磷农药中毒抢救失败原因探讨与对策

An Analysis on Death of Severe Organophosphorus Pesticide Poisoning and Management Strategy

目的 :探讨重症有机磷农药中毒的死亡原因 ,寻求提高抢救成功的对策。方法 :回顾性分析 6 32例重症有机磷中毒 ,其中死亡 10 6例的死亡时间及原因。结果 :早期死亡原因 :洗胃插管失败 (占 3.8% )和窒息 (2 .8% )。死亡原因依次为 :呼衰 (38.7% ) ;肺水肿 (16 .1% ) ;脑水肿 (14.1% ) ;阿托品中毒 (9.4% ) ;反跳 (7.5 % )等。结论 :彻底洗胃、正确使用阿托品、合理使用复能剂、预防并及时处理并发症和辅助方法的恰当选用等综合处理 。

Objective: To investigate the causes of death and management strategy for severe organophosphorus pesticide poisoning(SOPP). Methods: 106 death cases from 632 patients hospitalized with SOPP in the past 10 years were retrospectively analyzed for causes of death. Results: Major causes of death of the failure of orogastric intubation (3.8%) and asphyxia (2.8%) in the early clinical course.The most death cases were of inspiratory failure (38.7%) followed by pneumonedema (16.1%), encephaledema (14.1%), atropine poisoning (9.4%), and rebound (7.5%). Conclusion: Lavaging stomach completely, applying atropin and cholinesterase reactivators properly, preventing and treating complications in time, and selecting adjuvant treatment validly would raise survival rate.