急性有机磷农药中毒不同原因昏迷的临床特点  

Clinical Features of Coma due to Different Reasons in 152 Patients with Acute Organophosphorus Pesticide Poisoning

作　　者：程开俊[1] 郑玉成[1] 朱明俊 

机构地区：[1]福建省莆田市急救中心,351100 [2]莆田市第一医院急诊科

出　　处：《中国全科医学》2008年第12期1073-1074,共2页Chinese General Practice

摘　　要：目的分析急性有机磷农药中毒(AOPP)患者不同原因昏迷的临床特点。方法对我中心2001—2007年收住院抢救的152例AOPP昏迷患者的临床资料进行回顾分析,比较不同原因昏迷患者的临床特点。结果农药所致中枢性昏迷115例,服毒后5～10min出现腹痛、多汗,而后进入昏迷及出现肌肉纤维颤动。中间综合征致昏迷30例,出现于中毒后2～4d,患者不能抬头、呼吸困难、昏迷。阿托品中毒致昏迷4例,有大剂量使用阿托品史,伴有口干、皮肤干燥、脉搏>120次/min、体温上升,出现烦躁、昏迷。肺部感染高热致昏迷3例,患者痰多、高热、昏迷。农药所致中枢性昏迷患者死亡12例,其他原因昏迷患者全部抢救成功。结论AOPP昏迷病情危重,针对不同的原因采取有效的处理方案是抢救成功的关键。Objective To discuss clinical features of coma due to different reasons in 152 patients with acute organophosphorus pesticide poisoning （AOPP）. Methods Clinical characteristics of coma due to different reasons were analyzed in 152 patients with AOPP received in our center from 2001 -2007. Results There were 115 cases with central coma caused by pesticides, who presented abdominal pain, sweating, and then entered a coma and muscle fibrillation at 5 - 10 min after taking poison. Coma due to intermediate syndrome appeared in 30 cases at 2 - 4 d after poisoning, who were not able to raise their heads with a coma and difficulty in breathing. Four cases, whose coma was caused by atropine and appeared with dry mouth, dry skin, 〉 120 / min pulse, temperature rise and irritability, had a history of large - dose use of atropine,. Excessive phlegm, high fever and coma were the main symptoms in 3 cases with coma caused by lung infection high fever. Twelve cases with pesticide - caused central coma died, and the others were successfully rescued. Conclusion AOPP coma is usually in critical condition. Taking effective treatment options based on different inducing reasons is the key to successful rescue.

关 键 词：有机磷化合物 昏迷 阿托品 

分 类 号：R595.51[医药卫生—内科学]