急性有机磷农药中毒疗效分析及预防措施  

作　　者：陈晓宇[1] 柯欣[1] 罗金明[1] 

机构地区：[1]浙江省台州市第一人民医院ICU,318020

出　　处：《浙江临床医学》2015年第9期1467-1469,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨急性有机磷农药中毒（AOPP）现状，完善AOPP的防治工作，降低AoPP患者的病死率。方法对400例AOPP患者的发病时间、性别、年龄、就诊时间、中毒类型、临床表现、呼吸肌麻痹（RMP）的发生率、病死率、入院时的血清胆碱脂酶（ChE）、阿托品的用量进行统计分析。结果使用性中毒患者中男性占82．30％（P〈0．01）。使用性中毒和食物中毒的患者中重型临床表现例数较少（P〈0．01）。口服中毒者的病死率（22．27％）、RMP发生率（43．36％）；阿托品维持量（50．0mg）、阿托品总量（836．0mg）；恢复至口服维持的时间（9．3d）较长，与其他两种有显著性差异（P〈0．01）。使用性中毒患者的就诊时间（29．1h）较晚（P〈O．05）。随年龄增大、病死率有上升趋势。结论使用性中毒发病率有逐渐下降趋势，其阿托品用量少、恢复快、RMP的发生率和病死率低。需加强有机磷农药的管理，限制剧毒高毒类农药的生产、销售和使用。入院时的血清胆碱脂酶值与病情及预后不相关。在治疗上根据不同的类型中毒和临床表现选择合适的治疗方案，降低痛死率。Objective To decrease the mortality of the acute organophosphorus pesticide poisoning （ AOPP ） and improve the preventment and therapy of it by investigating AOPP in the countryside region. Methods A retrospective review was conducted about the difference of episode time, sex, age, time of medical treatment, type of intoxication, clinical situation, incidence rate of respiratory muscular paralysis （ RMP ） , mortality, prior to admission of serum cholinesterase, atropinic dosage of 400 patients. Results The rate of used poisoning in male is 82.30%.The case of middle and gravis type are few which poisoned by used or food poisoning, the mortality （ 22.27% ） , the incidence rate ofRMP （ 43.36% ） , the maintenance dose of atropine （ 50.0mg ） , the total amount of atropine （ 836.0mg ） were higher and the time of recover to maintaining by mouth was longer than the other two groups, the difference was significant （P〈0.01） . The poisoned patients of using AOPP were send to hospital lately （ P〈0.05 ） . The mortality rate rose in older patients. Conelusions Intoxicated patients because of using phosphate pesticide are fewer in recent year, need lower dosage of Atropine, recovery quickly and have lower incidence rate of RMP and mortality. More attention must be paid to enhance the management and restrict the producing, selling and using of phosphate pesticide.in order to decrease disease incidence of AOPP.The prior to admission of serum cholinesterase is not related with state of an illness and prognosis.We must choose proper therapeutic regimen in accordance with different route of intoxication and clinical situation to decrease mortality.

关 键 词：有机磷农药 中毒 胆碱酯酶 阿托品 

分 类 号：R595.4[医药卫生—内科学]