急性有机磷农药中毒中间综合征诊断与治疗  

Clinical analysis of intermediate syndrome in acute organophosphorus pesticide poisoning

作　　者：洪军[1] 

机构地区：[1]安徽省立医院内科,合肥230001

出　　处：《安徽医学》2005年第4期269-270,共2页Anhui Medical Journal

摘　　要：目的探讨急性有机磷中毒(AOPP)中间综合征(IMS)的诊断治疗。方法对16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14%,IMS症状出现在急性中毒后24～96小时,16例均出现呼吸困难、抬头困难、屈颈肌力弱,血清ChE活力低下,当IMS患者出现呼吸衰竭时应使用呼吸机治疗,同时合理使用阿托品、胆碱酯酶复能剂,除2例因经济困难放弃治疗,其余均治愈。结论IMS发生率及病死率高,早期诊断及时治疗是提高IMS抢救成功率、降低病死率的关键。Objective To investigate the diagnosis and treatment of intermediate syndrome(IMS) after acute organophosphorus pesticides poisoning (AOPP).Methods 16cases were retrospectively analysed focusing on clinical manifestarions,cholinesterase acrivity,eat,therapeutic effects of atropine,cholinesterase acrivator,mechanical ventilarion and outcome were observed.Results of the 16 patients with IMS,the IMS incidence accounted for 14% of the AOPP hospitalized coincidentally.The symptoms of IMS occurred at 24～96 hours after acute poisoning.All the 16 cases showed difficulty in breathing and elevating their heads,weakness of the flexor muscles of neck.Their cholinesterase activity was lower.two refused.The patients with IMS,should be put under treatment with respirator and treated with pralidoxime in addition to atropine.when they have difficulty in breathing.Except for two patients refused treatment,remained Fourteen were cured.Conclusion IMS has a high incidence and deaty rate Early diagnose with promptly treatment is a key factor to raise survive rate and redece death rate.

关 键 词：急性有机磷农药中毒 中间综合征 胆碱酯酶 临床表现 阿托品 

分 类 号：R595.4[医药卫生—内科学]