急性有机磷农药中毒中间综合征10例临床分析  

INTERMEDIATE SYNDROME AFTER ACUTE ORGANOPHOSPHORUS PESTICIDES POISONING: CLINICAL ANALYSIS OF 10 CASES

作　　者：秦复康[1,2] 徐海滨[1,2] 陈玉萍[1,2] 刘统俊[1,2] 曹兴琴 黄金祥[1,2] 贺锡雯[1,2] 何凤生[1,2] 

机构地区：[1]山东省滕州市中心人民医院 [2]中国预防医学科学院劳动卫生与职业病研究所

出　　处：《中华内科杂志》1997年第9期613-616,共4页Chinese Journal of Internal Medicine

基　　金：卫生部科研基金

摘　　要：为探讨有机磷农药中毒中间综合征（ＩＭＳ）的诊断与治疗，对１０例该综合征进行临床分析，结果显示ＩＭＳ的发生率为同期入院的急性有机磷农药中毒患者人数的５．４％。患者多为口服重度中毒者，ＩＭＳ症状出现在急性中毒后７～６８小时。首发症状多为饮水发呛、声音嘶哑（第Ⅸ、Ⅹ对颅神经所支配的肌力弱），并可见屈颈肌和肢体近端肌肌力弱，不伴感觉障碍。出现呼吸肌麻痹者，因危及生命，多需及时建立人工气道和机械通气。本组ＩＭＳ持续６～３０天，平均１３天，未发生死亡。对有关农药品种、ＩＭＳ的发生发展及病程转归、救治原则和发病机制进行了初步探讨。Ten patients with intermediate syndrome (IMS) after acute organophosphorus (OP) pesticides poisoning were observed. The occurrence rate of IMS was 5.4% among total inpatients of acute OP poisoning in the same period. The majority of IMS cases were of severe oral OP poisoning. Seven to 68 hours after poisoning there were initial signs including motor weakness of muscles innervated by the 9th and 10th cranial nerves (e.g. dysphagia, hoarse voice). The neck flexor muscles and proximal limb muscles were also involved. Patients with respiratory muscle paralysis usually required urgent tracheal intubation and mechanical ventilation. The IMS in this group persisted for 6～30 days (mean 13 days) with no fatality. The relevant kinds of pesticide, the development and regression of IMS, and the treatment and possible mechanism of IMS were discussed.

关 键 词：农药中毒 中间综合征 有机磷农药 治疗 

分 类 号：R595.405[医药卫生—内科学]