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作者曾遇到一例急性三氯化磷中毒误诊致死病例,为引起同道注意,兹报告如下。 病例摘要 患者××,女性,22岁,为某药厂甲胺磷车间三氯硫磷合成工序操作工.既往体健,该患于就诊前1小时,因三氯硫磷合成釜爆炸,致使以生产原料三氯化磷为主的蒸气弥散于车间空气中,慌乱中患者跌倒在下风向,约经8～9分钟后被人救出。当时患者神志清醒,自觉胸闷、呼吸困难、呛咳,眼睁不开。现场未做任何处置,急送×院急诊室就诊后入院。查体:神清合作,口唇无紫绀,瞳孔等大整圆。心脏听诊无杂音,心率、呼吸频率正常,双肺下部有少量干性罗音,腹软,肝脾未触及。生理反射存在,病理反射未引出。实验室检查:白细胞10.8 ×10~9/L,中性74％,淋巴24％,单核2％。血液胆硷
The author has encountered a case of misdiagnosis and death of acute phosphorus trichloride poisoning. To draw the attention of the public, I hereby report the following. Case Summary Patients × ×, female, aged 22, was a trichloroacethin synthesis operator for methamidophos in a pharmaceutical factory. Previously healthy body weight was found at 1 hour prior to the visit due to the explosion of the trichloroacetyl synthesis reactor The main raw material phosphorus trichloride vapor dispersed in the workshop air, panic patients fell downwind, about 8 to 9 minutes after being rescued. At that time, patients with conscious, conscious chest tightness, difficulty breathing, cough, eyes can not open. The scene did not make any disposal, emergency hospital × emergency room after admission. Examination: Shenqing cooperation, lips without cyanosis, pupils and other large whole circle. Cardiac auscultation without noise, heart rate, respiratory rate, lower lungs have a small amount of dry rales, abdominal soft, liver and spleen not touched. Physiological reflex exists, the pathological reflex did not lead. Laboratory tests: white blood cells 10.8 × 10 ~ 9 / L, 74% neutral, lymph 24%, mononuclear 2%. Blood choline