急性重度甲拌磷中毒的临床特点分析  

Clinical evaluation and analysis of acute phorate poisoning

作　　者：梁绍钦 韩若东 宋克义[1] LIANG Shao-qin, HAN ROU-dong, SONG Ke-yi(Department of Critical Care Medicine, Bozhou People＇ s Hospital, Bozhou, Anhui 236800, Chin)

机构地区：[1]亳州市人民医院重症医学科,安徽亳州236800

出　　处：《中华全科医学》2018年第4期568-569,641,共3页Chinese Journal of General Practice

基　　金：黎介寿肠道屏障研究专项基金(LJS-201605)

摘　　要：目的比较重度甲拌磷中毒与重度非甲拌磷有机磷中毒的临床特点。方法选取2014年3月—2017年3月收住亳州市人民医院重症医学科50例重度有机磷中毒患者进行回顾性分析,根据有机磷药物中毒种类分为甲拌磷组(22例)和非甲拌磷组(28例),比较2组中间综合征发病例数、胆碱酯酶开始恢复时间、长托宁用量、气管切开例数、住院时间、病死率。结果与非甲拌磷组相比,(1)甲拌磷组中间综合征发病例数为14例,较非甲拌磷组(0例)高;(2)甲拌磷组胆碱酯酶开始恢复时间为(330.55±8.64)h,较非甲拌磷组(67.71±6.42)h长;(3)甲拌磷组长托宁用量为(58.00±12.92)mg,较非甲拌磷组(8.35±2.66)mg多;(4)甲拌磷组气管切开例数为18例,较非甲拌磷组(2例)多;(5)甲拌磷组住院时间为(19.50±6.39)d,较非甲拌磷组(10.57±3.54)d长,2组间比较差异有统计学意义(P<0.05);(6)甲拌磷组病死率为4.54%,非甲拌磷组病死率为7.14%,2组病死率相比差异无统计学意义(P>0.05)。结论重度甲拌磷中毒患者并发症较多,病程较长,后续治疗负担较重。Objective To compare the clinicaJ features of acute severe poisoning of phorate and other non-phorate pesti- cide. Methods There was a retrospective analysis of 50 cases of patients with severe organophosphorus poisoning in our hospital from March, 2014 to March, 2017 ,which were divided into phorate poisoning group （22 cases） and other non- phorate poisoning group （28 cases） according to different toxicity of pesticide. The intermediate syndrome cases, cholinesterase recovery time, the total amount of penehyclidine hydrochloride dosage, traeheotomy cases, hospitalization time and fatality rate were observed. Results Compared with other non-phoratepoisoning group： （1）phorate poisoning group has a higher incidence of intermediate syndrome （ 14 vs. 0） ; （2）longer cholinesterasc recovery time [ （330.55 ± 8.64 ） h vs. （67.71± 6.42） h] ; （3）higher penehyelidine hydrochloride dosage [ （58.00 ± 12.92） mg vs. （8.35± 2.66） mg] ; （4）more cases of tracheotomy （ 18 vs. 2） ; （5）longer hospitalization period [ （ 19.50 ± 6.39） d vs. （ 10.57 ± 3.54） d ]. There was a significant difference in above clinical observatiorl indexes between the two groups （P 〈 0.05 ） ; （6）The fatali- ty rate of phorate poisoning group was 4.54% , and the fatality rate of non-phorate poisoning group was 7.14%. There was no difference in fatality rate between the two groups （ P 〉 0.05 ）. Conclusion Acute phorate poisoning has many complications, long hospitalization time and heavy follow-up treatment burden.

关 键 词：有机磷中毒 甲拌磷中毒 临床分析 

分 类 号：R595.4[医药卫生—内科学]