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我科近5年来,抢救重度有机磷农药经口服中毒患者45例,成功37例,死亡8例.现介绍护理体会. 本组病人均先在门诊洗胃、注射阿托品、输液等后入院.入院后首先应注意神态、瞳孔变化情况,并彻底清除被农药污染的衣服、皮肤、头发,以免毒物继续吸收.因有机磷可直接抑制呼吸中枢,导致呼吸衰竭.另外,有机磷中毒后所致的脑血管痉挛、脑微循环功能障碍、脑血管通透性增加、低氧血症等,是形成脑水肿导致中枢性呼吸衰竭的重要原因,必须注意呼吸状态.同时,因毒蕈碱样作用,使支气管痉挛,分泌物增加,重者可发生肺水肿、因此,保持呼吸道通畅,防治急性呼吸衰竭,是抢救有机磷中毒的关键.
In the past 5 years, our department has rescued 45 cases of severe organophosphorus pesticide oral poisoning, 37 cases were successful, and 8 cases died .Nowadays, nursing experience is introduced. All patients in this group were admitted to the hospital after gastric lavage, injection of atropine, infusion and so on. After the first attention should be paid demeanor, pupil changes, and completely remove pesticide-contaminated clothing, skin, hair, so as to avoid the continued absorption of poison because of organic phosphorus can directly inhibit the respiratory center, leading to respiratory failure.In addition, organophosphate poisoning caused by Cerebral vasospasm, cerebral microcirculation dysfunction, increased cerebral vascular permeability, hypoxemia, is an important cause of cerebral edema leading to central respiratory failure, we must pay attention to respiratory status.At the same time, due to muscarinic effect, The bronchial spasm, increased secretions, severe pulmonary edema may occur, therefore, to maintain airway patency, prevention and treatment of acute respiratory failure, is the key to salvage organophosphate poisoning.