急性有机磷农药中毒并发呼吸衰竭原因分析及临床对策

目的:探讨急性有机磷农药中毒(AOPP)并发呼吸衰竭(RF)的发生原因及临床对策。方法:回顾性分析33例AOPP并发RF的临床表现及治疗情况。结果:AOPP并发RF原因有多方面,除有机磷的直接毒性作用外,还有阿托品中毒、脑水肿、中间综合征及中毒反跳等因素的影响。早期合理使用阿托品及复能剂,早期气管插管呼吸机辅助呼吸是治疗的关键,避免阿托品的过量使用,预防和治疗脑水肿,配合血液灌流,输新鲜血等综合性治疗措施有利于预防和治疗呼吸衰竭。结论:AOPP并发RF原因多方面,早期发现和识别,采取针对性的防治措施,可明显提高抢救成功率。

Cause Analysis and Clinical Countermeasure of Respiratory Failure in Acute Organophosphorus Pesticide Poisoning

Objective: To investigate the cause and clinical countermeasure of respiratory failure(RF) in acute organophosphorus pesticide poisoning(AOPP). Methods: 33 patients of RF in AOPP were retrospectively analyzed. Results: 2 patients were cured, 10 patients were died, 1 patient was serf-discharged from hospital, the mortality was 30.3%. Conclusion: The causes of RF in AOPP were varieties, there were poisoning of atropine, intermediate syndrome(IMS), cerebral edema, and poisoning recurrence, besides the toxicity of organophophorus. Early discovered and identified, and to take corresponding clinical countermeasure, can bring advantages in treatments and preventions of RF in AOPP and decrease the mortality.