皮肤接触敌敌畏中毒后的应急洗消研究

目的比较皮肤接触有机磷杀虫剂敌敌畏中毒后不同洗消方法的疗效。方法大耳白兔皮肤染毒建立模型,染毒前后重复测血中乙酰胆碱酯酶（AchE）的变化,结合洗消开始时间评价不同洗消液（清水、皂水、碳酸氢钠溶液）的洗消效果。结果敌敌畏染毒动物皮肤1 h后血清AchE已降至正常30%以下,达重度中毒,此时洗消效果不显著;开始洗消时间越早,AchE抑制程度越小,中毒程度越低;中毒30 min后,各实验组洗消效果比较,差异无统计学意义（P〈0.05）。结论在职业性接触中毒事件中,第一时间开始洗消是关键,对减少毒物吸收、降低中毒严重程度、争取后期院内治疗时间意义重大。敌敌畏中毒后10 min内开始洗消,疗效最佳;中毒后时间超过30 min,中毒程度较深,碱性洗消液已丧失优势。

Emergent decontaminations rearch of dichlorvos poisoning with skin contact

Objective To compare the effect of different decontamination methods of dichlorvos poisoning with skin contact.Methods On the establishment of skin exposure to dichlorvos model,the levels of blood acetylcholinesterase(AchE) were tested in different time point,and the effect of different decontaminate liquid(water,soap water,sodium bicarbonate solution) were analyzed combined with the start time of the decontamination.Results With skin exposed to dichlorvos after 1 h,the blood AchE had decreased to 30% or less,which was severe poisoning,the decontamination effect was not significant;the sooner was the decontamination,the smaller was the AchE inhibition,and lower level of intoxication;there were no statistically significant difference between different experiment groups in decontamination effect after 30 minutes.Conclusion In the case of dichlorvos poisoning,it is significant to begin decontaminating as soon as possible to reduce absorption,decrease the severity,and save time for post-hospital treatment,it is the best of less than 10 minutes;alkaline decontamination solution have lost the advantages when the poisoning time has lasted for more than 30 minutes,then decontamination should immediately begin with no consideration of decontamination solution.