静脉-动脉体外膜肺氧合救治敌敌畏中毒致难治性休克3例  

Application of extracorporeal membrane oxygenation technique in patients with refractory shock caused by dichlorvos poisoning

作　　者：王停停 刘清岳[1] 孙甲君[1] Wang Tingting;Liu Qingyue;Sun Jiajun(Department of Intensive Care Unit,The Affiliated Liaocheng No.2 People's Hospital of Shandong First Medical University,Linqing 252600,China)

机构地区：[1]山东第一医科大学附属聊城市第二人民医院重症医学科,临清252600

出　　处：《中华劳动卫生职业病杂志》2023年第9期688-692,共5页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：山东省医药卫生科技发展计划项目(202010001261)。

摘　　要：敌敌畏中毒可导致机体出现毒蕈碱(M)样症状、烟碱(N)样症状和中枢神经系统表现。当重度中毒合并难治性休克时,死亡率超过60%。目前,体外膜肺氧合(ECMO)技术用于中毒的研究越来越多,但ECMO用于救治敌敌畏中毒导致的难治性低血压目前尚无报道。我们对3例静脉-动脉体外膜肺氧合(VA-ECMO)救治急性重度敌敌畏中毒导致难治性休克的成功案例进行分析,探索VA-ECMO在重度敌敌畏中毒患者中的有效性。Dichlorvos poisoning can cause muscarinic(M)-like symptoms,nicotinoid(N)-like symptoms and central nervous system manifestations.When severe poisoning is combined with refractory shock,the mortality rate exceeds 60%.At present,there are more and more studies on ECMO for poisoning,but there is no report on ECMO for treating refractory hypotension caused by dichlorvos poisoning.We analyzed 3 successful cases of veno-arterial extracorporeal membrane oxygenation(VA-ECMO)in the treatment of refractory shock caused by acute severe dichlorvos poisoning to explore the effectiveness of VA-ECMO in patients with severe poisoning.

关 键 词：中毒 敌敌畏 毒蕈碱 烟碱 体外膜肺氧合 难治性休克 

分 类 号：R595.4[医药卫生—内科学]