112例有机磷农药中毒临床分析

目的总结有机磷农药中毒（aggregate organic pesticide poisoning，AOPP）病人的抢救经验。方法回顾性分析1998年1月-2007年6月112例AOPP病人的临床资料，对比性分析不同治疗方法的临床疗效。结果早年在有机磷农药中毒病人的急救中主要依赖洗胃等清除隔离毒物，复能刺、胆碱能拮抗荆应用，以及支持对症，预防和控制并发症等治疗措施。重度中毒者住院期间并发中间期综合征、后神经损害和病死率较高。血液灌流治疗在有机磷农药中毒急救中广泛应用，使AOPP者住院时间缩短，阿托品用量减少，降低了并发症发生率和死亡率。血液灌流串联血液透析，对重度中毒者合并休克、低体温、代谢性酸中毒等，有促进血液保温（特别是冬季）、纠正酸中毒、抗休克、预防急性肾衰等作用。结论在AOPP治疗中HP串联HD优于HP。

112 cases of clinical analysis to aggregate organic pesticide poisoning patients

Objective To sum up the experience to rescue the patient with aggregate organic pesticide poisoning(AOPP). Methods A retrospective analysis of 112 cases of AOPP patient's clinical data from January 1998 to June 2007 and a comparative analysis of different treatment of the clinical efficacy.Results In the early days of AOPP patients in the emergency,mainly depended on the removal of isolation poison by gastric lavage,applying rehabilitation and cholinergic antagonist,and such treatment measures as support for symptoms,prevention and control of complications.The severe were complicated with intermediate syndrome,rear nerve damage and a higher mortality during treatment at hospital.The hemoperfusion treating widely used in the emergency so as to shorten the days of hospitalization to the AOPP patients,to reduce the amount of atropine,and to shrink the incidence of complications and mortality.Hemoperfusion with haemodialysis had the functions of promoting to keep the blood warm(esp.in winter),correcting acid poisoning,anti-shocking and preventing the acute renal failure to the severe with shock,low body temperature,metabolic acidosis and so on.Conclusions Hemoperfusion is superior to haemodialysis in AOPP treatment.