血药浓度检测在急性有机磷中毒患者救治中的应用

目的：探讨血药浓度检测在急性有机磷中毒（AOPP）患者救治中的应用。方法：选择医院急诊室AOPP患者采用气相色谱法进行血药浓度监测，研究血液毒物存在时间及血药浓度高低、血液毒物持续存在时间与血液胆碱酯酶（ChE）、氯磷定应用、住院时间的关系。结果：AOPP患者血液毒物持续存在时间多在3～7d，较传统观点明显延长；初始血药浓度较高和血液毒物持续存在时间较长者ChE恢复慢，氯磷定应用时间长、剂量大，患者病情重、住院时间长。结论：血药浓度监测对AOPP的病情判断、指导治疗、改善预后有重要意义。

Clinical effects of testing the concentration of organophosphorus pesticides in serum

Objective： To study how to diagnose, treat and evaluate the patient with acute organophosphoruspesticides poisoning （AOPP） by testing the concentration of AOPP in serum. Methods： We collected all the AOPP poisoned patients. The concentration of AOPP in serum were tested by vapor phase chromatography in each patient to study the relationship between the level of ChE in serum, thedose of pralidoxime chloride, stage of hospitalization and the concentration of AOPP in serum. Results： The time which AOPP could be tested in serum was from 3 to 7 days. Which was significantly longer than the traditional view. If the initial concentration of AOPP was higher and the time which AOPP could be tested in serum was longer, the patients were more severely, the level of ChE in serum recovered slowly, the patients needed high doses of pralidoxime chloride and longer time of therapy, stage of hospitalization was longer. Conclusion： There is an important role in judging the severity, directing the treatment and improving the survival rate of AOPP poisoned patients by testing the concentration of AOPP in serum.