急性有机磷农药中毒致中间综合征的影响因素分析(附108例报告)  

Clinical analysis on influencing factor of intermediate syndrome secondary to acute organophosphorus pesticide poisoning (108 cases)

作　　者：黄艳 杨春云[2] 

机构地区：[1]长沙市第四人民医院急诊科,湖南长沙410006 [2]怀化市第五人民医院神经内科,湖南怀化418000

出　　处：《中国现代医学杂志》2009年第5期731-734,740,共5页China Journal of Modern Medicine

摘　　要：目的探讨急性有机磷农药中毒发生中间综合征(IMS)的影响因素。方法分析1335例急性有机磷农药中毒病例,对患者性别、年龄、是否空腹中毒、毒物的毒性程度、重要脏器原有基础病、诊治是否及时、洗胃情况、阿托品化时间、是否使用影响神经肌肉接头药物等9方面进行分析,揭示其与中间综合征发生的关系。结果中间综合征的发生率为8.1%,病死率为45.5%;老年患者较青年和中年人更易发生(P<0.01),中毒前重要脏器已有基础病变者较无病变者更易发生中间综合征,差异有显著性(P<0.01);空腹中毒较餐后中毒、延缓治疗较及时治疗、洗胃不彻底较洗胃彻底者更易发生中间综合征(P<0.05);救治有机磷农药中毒时,使用氨基糖苷类药有可能增加发生中间综合征的机会;最易发生中间综合征的有机磷农药是中度毒性者,其次才是高毒及剧毒者(P<0.05)。结论急性有机磷农药中毒发生中间综合征受多种因素的影响,熟悉这些因素对指导治疗、改善预后有重要意义。[Objective] To explore the influencing factor of intermediate syndrome （IMS） secondary to acute organophosphorus pesticide poisoning. [Methods] The clinical data of 1335 patients with acute organophosphorus pesticide poisoning were analyzed in 9 aspects in order to reveal the relationship between intermediate syndrome （IMS） and them, which included sex, age, empty stomach or not, toxicity of the poisonous substance, original diseases of important organs, prompt diagnosis and treatment or not, thorough gastric lavage or not, atropinizating time and receiving drugs influencing myoneural junction or not. [Results] The incidence and case fatality rate of intermediate syndrome secondary to acute phosphate pesticide poisoning was 8.1%,45.5%,respectively.The incidence of intermediate syndrome in senile patients was higher than that in young and middle-aged people （P 〈0.01）. The incidence of intermediate syndrome in the patients with original diseases of important organs before being poisoned was significandy higher than that in the patients without those （P 〈0.01）. Intermediate syndrome secondary to acute phosphate pesticide poisoning more frequendy occurred in the patients with empty stomach, delayed treatment and incomplete gastric lavage than in those with the opposite conditions （P 〈0.05）. Aminoglycosides would increase the incidence of intermediate syndrome in treating acute phosphate pesticide poisoning. Intermediate syndrome most frequently occurred in acute phosphate pesticide poisoning of midrange and high, rank poisons in sequence （P 〈0.05）. [Conclusion] The incidence of intermediate syndrome secondary to acute phosphate pesticide poisoning is influenced by a variety of factors, which are to be grasped with important value in guiding treatment and improving prognosis.

关 键 词：急性有机磷中毒 中间综合征 影响因素 

分 类 号：R135.1[医药卫生—劳动卫生]