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近四年来,我院共抢救有机磷农药中毒患者61例。治愈57例,死亡4例。对于有机磷农药中毒在诊治过程中值得探讨的一些问题,初步体会如下: 一、掌握特点,避免误诊。因毒物接触史不清,临床症状复杂等原因,常导至对本病的误诊。故诊断时要重视服毒史、接触史及典型体征。瞳孔的变化有较大的参考价值,在付交感神经兴奋时瞳孔缩小,但重度有机磷中毒累及中枢及动眼神经时,瞳孔也可扩大。肌肉震颤、呕吐物及体表散发大蒜味,及血中胆碱酯酶活力测定,都有助于诊断。发现有类似症状且原因不明者,应高度怀疑为本病,必要时做阿托品试验治疗。二、及时洗胃,彻底清除毒物是抢救成败的关键。抢救时常用的洗胃液以1/5000高锰酸钾液(对
In the past four years, our hospital salvaged 61 cases of organophosphate pesticide poisoning patients. 57 cases were cured, 4 died. Organophosphorus pesticide poisoning in the diagnosis and treatment of some of the problems worth exploring, the initial experience as follows: First, grasp the characteristics to avoid misdiagnosis. Due to unclear history of poison exposure, clinical symptoms and other reasons, often lead to misdiagnosis of the disease. Therefore, diagnosis should take drug history, history of exposure and typical signs. Pupil changes have a greater reference value, pay attention to the sympathetic excitement when the pupil shrinks, but severe organophosphorus poisoning involving the central and oculomotor nerve, the pupil can also be expanded. Muscle tremor, vomit and body surface distribution of garlic, and blood cholinesterase activity determination, are helpful in the diagnosis. Found similar symptoms and unexplained persons, should be highly suspected of this disease, if necessary, do atropine test treatment. Second, timely gastric lavage, the complete removal of poison is the key to the success of the rescue. Salvage gastric juice commonly used to rescue 1/5000 potassium permanganate solution (right