摘要
目的 :探讨急性有机磷农药中毒 (AOPP)中间综合征 (IMS)的诊断、治疗及发病因素。方法 :对 13例IMS的临床表现、血清胆碱酯酶 (ChE)活力、病程等进行分析 ,并观察药物及呼吸机治疗的疗效和转归。结果 :IMS的发生率占同期收治的AOPP的 10 .8% ,IMS患者多发生于重度中毒者 ,占 84.6 %。IMS病状出现在急性中毒后 2 8～ 114h。 13例均出现呼吸困难、抬头困难、屈颈肌力弱及肢体近端肌无力。血清ChE活力 0～ 15U。IMS持续 8～ 2 3d ,经抢救治愈 6例(4 6 .15 % ) ,死亡 6例 (4 6 .15 % ) ,放弃治疗 1例。结果 :IMS患者出现呼吸衰竭时应使用呼吸机治疗。发病因素多与①AOPP病情轻重 ,②AOPP急性期的治疗 (阿托品剂量过大、复能剂用量不足 ) ,以及③农药品种有关。
Objective:To investigate the causing factors as well as the diagnosis and treatment of intermediate syndrome (IMS) after acute organophosphorus pesticides poisoning (AOPP). Methods:13 cases were retrospectively analysed focusing on clinical manifestations, cholinesterase activity,etc. The therapeutic effects of atropine, cholinesterase activator, mechanical ventilation and outcome were observed.Results:Of the 13 patients with IMS, 11 cases were severely poisoned ( 84.6%) , the IMS incidence accounted for 10.8% of the AOPP hospitalized coincidentally.The symptoms of IMS occured at 28～114 hours after acute poisoning.All the 13 cases showed difficulty in breathing and elevating their heads, weakness of the flexor muscles of neck and proximal limbs without concomitant sensory disturbance.Their cholinesterase activity was 0～15 U.Most IMS were accompanied with hypoxemia before the treatment with respirator.The symptoms of IMS lasted for 8～23 days, six were cured ( 46.15% ), six died ( 46.15% ), one refused treatment ( 7.7% ).Conclusion:The patients with IMS, when they have difficulty in breathing, must be put under prompt treatment with respirator. The development of IMS is related to ① the degree of severity of AOPP,② The appropriatness of acute phase treatment,③ pesticide assortment.
出处
《内科急危重症杂志》
2001年第4期203-205,共3页
Journal of Critical Care In Internal Medicine
关键词
有机磷中毒
中间综合征
发病因素
Acute organophosphorus poisoning Intermediate syndrome Causing factors
