重症有机磷中毒31例致死原因分析

目的 分析探讨重症有机磷中毒患者的致死原因及经验教训.方法 对31例重症有机磷中毒死亡病例的临床表现、治疗方法、致死原因进行回顾性分析.结果 31例死亡患者中,12例死于胆碱危象(38.70％),16例死于呼吸衰竭(51.61％),2例死于阿托品中毒(6.45％),1例死于解磷定过量(3.23％).中间综合征发生率为6.01％,病死率为16.94％.结论 毒物清除不彻底,阿托品与胆碱酯酶复能剂应用不当,对呼吸衰竭患者机械通气治疗方法不当,合并重要脏器原有基础病变是导致死亡的主要原因,准确判断病情是降低病死率的关键.

Analysis of the cause of death in 31 severe organophosphorus poisoning

Objective To explore cause of death and the lessons learned in critically ill patients with organophosphate poisoning. Methods The clinical manifestations, treatment, cause of death in 31 patients with severe organophosphate poisoning deaths were retrospectively analyzed. Results 31 deaths of patients, 12 patients died of cholinergic crisis（38.70% ）, 16 patients died of respiratory failure（51.61% ）,2 patients died of atropine intoxication （6. 45 % ）, 1 patient died of the solution be excessive phosphorus （3.23%）. 6.01% incidence of intermediate syndrome, mortality was 16.94%. Conclusion Poison not completely clear, atropine and eholinesterase agents applied inappropriately, patients with mechanical ventilation for respiratory failure improper treatment, the merger is an important organ of the original basis of disease leading cause of death, accurately determine the condition is the key to reducing mortality.