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目的:探讨经口有机磷农药中毒并发胃黏膜损害甚至出血的原因及在治疗过程中的注意点。方法:系统性回顾分析2000年1月～2010年12月经口有机磷农药中毒患者26例,胃镜下观察胃黏膜病变情况。结果:胃部表现,18例镜下见胃黏膜红白相间充血,8例伴有散在性糜烂点,表面附着白色絮状物,其中3例在胃窦部有陈旧性出血点,1例在胃体部见浅表溃疡,7例呈现反流性胃炎的镜下特征,大部分是胃蠕动明显减弱,贲门、幽门闭合功能差。食管,12例患者镜下食管黏膜表现为充血水肿及散在糜烂面,以食管下段近贲门处尤为明显,未见瘢痕挛缩。结论:经口有机磷农药中毒在洗胃时轻柔,以免机械性损伤;在用药过程中要充分地估计胃动力障碍造成胆汁反流对消化道黏膜的损伤和有机磷农药本身凝血酶形成抑制,适当应用制酸剂和止血药物等综合措施,防止消化道出血的发生。
Objective: To investigate the causes of oral organophosphorus pesticide poisoning complicated by gastric mucosa damage and even bleeding and the points of attention in the course of treatment. Methods: A systematic review of 26 patients with oral organophosphorus pesticide poisoning from January 2000 to December 2010 was performed. Gastric mucosal lesion was observed under endoscopy. Results: The stomach showed 18 cases of gastric mucosa red and white congestion, 8 cases accompanied by scattered erosion, the surface of the white floc attached to the surface, of which 3 cases of gastric bleeding in the old bleeding point in 1 case Gastric ulcers seen in superficial body, 7 cases showed reflux gastritis microscopic features, most of the gastric motility was significantly weakened, cardia, pylorus closure function is poor. Esophagus, 12 cases of esophageal mucosa showed congestion and edema and scattered erosion surface to esophageal proximal cardia Department is particularly evident, no scar contracture. Conclusion: Oral organophosphorus pesticide poisoning mild gastric lavage, so as to avoid mechanical damage; in the course of medication to fully estimate gastric motility disorders caused by bile reflux of gastrointestinal mucosa injury and organophosphorus pesticide itself thrombin formation inhibition, Appropriate application of antacids and hemostatic drugs and other comprehensive measures to prevent the occurrence of gastrointestinal bleeding.