论文部分内容阅读
目的探讨急性有机磷农药中毒(AOPP)中间综合征(IMS)的诊断治疗。方法对15例IMS的临床表现、血清胆碱酯酶(ChE)活力、病程等进行分析,并观察药物及呼吸机治疗的疗效和转归。结果IMS的发生率占同期收治的AOPP的13.8%,IMS症状出现在急性中毒后36～118h,15例均出现呼吸困难、抬头困难、屈颈肌力弱及肢体近端肌无力,血清ChE活力低下,当IMS患者出现呼吸衰竭时应使用呼吸机治疗,同时合理使用阿托品、胆碱酯酶复能剂,经抢救治愈9例,死亡3例,放弃治疗3例。结论IMS发生率及病死率高,早期诊断及时治疗是提高IMS抢救成功率、降低病死率的关键。
Objective To investigate the diagnosis and treatment of acute organophosphorus pesticide poisoning (AOPP) intermediate syndrome (IMS). Methods The clinical manifestations, serum cholinesterase (ChE) activity and duration of IMS were analyzed in 15 cases. The curative effect and prognosis of drugs and ventilator were observed. Results The incidence of IMS accounted for 13.8% of the AOPP admitted in the same period. IMS symptoms occurred 36 to 118 hours after acute poisoning. All 15 patients had dyspnea, difficulty in raising their head, weak flexion and weakness of the proximal neck, and serum ChE activity Low, when respiratory failure occurs in patients with respiratory failure should be treated with ventilator, while the rational use of atropine, cholinesterase agent, after salvage in 9 cases, 3 died, give up treatment in 3 cases. Conclusion The incidence of IMS and mortality is high. Early diagnosis and timely treatment are the keys to improve the success rate of IMS and reduce the mortality rate.