重度有机磷农药中毒患者血清胆碱酯酶和电解质的动态变化及其临床意义.DOCVIP

临床医学论文-重度有机磷农药中毒患者血清胆碱酯酶和电解质的动态变化及其临床意义 ????????????? 作者：王勇，张玲玲，俞小忠，丁体龙，程冕，严家春 【关键词】? 重度有机磷农药 　??? ［摘要］? 目的? 探讨重度有机磷农药中毒患者的血清胆碱酯酶（CHE）和电解质的变化规律。 ??? 方法? 19例重度有机磷农药中毒患者，分别检测中毒后第1、2、3、5、7天的血清胆碱酯酶（CHE）、电解质，并与健康组（N）对照，比较各组之间指标的差异。 ??? 结果? CHE在中毒时显著降低，3天后呈明显升高趋势，钾离子在中毒后逐渐降低，3天后降至最低，而后逐渐趋于正常；钠、氯离子与对照组比较无明显差异。 ??? 结论? CHE、K+测定可作为监测有机磷农药中毒患者的病情及预后的常规指标。 ???? In vivo dynamic changes and clinical significance of blood cholinesterase and electrolyte in patients with severe organic phosphorus intoxication ??? ［Abstract］? Objective? To research the changes of blood cholinesterase,electrolyte in patients with severe organic phosphorus intoxication. ??? Methods? 19 patients with severe organic phosphorus intoxication as severe group and healthy volunteers served as normal group,blood samples of these two groups were collected to measure theirs’ blood cholinesterase and electrolyte on 1st，2nd，3rd，5th，7th day. ??? Results? The level of blood cholinesterase and K+ in severe group were higher than those in normal group on 1，2，3，5（P＜0.01，P＜0.05，P＜0.001）.The level of Na+，Cl+ in severe group no changes than those in normal no 1，2，3，5，7（P＞0.05）.In pathological examinations,a great number of white blood cell were detected. ??? Conclusion? It is important to monitoring the blood cholinesterase and K+ changes in patients with severe organic phosphorus intoxication,the level of blood cholinesterase and K+ can be used as indexes helped to judge the patient’s condition. ??? ［Key words］? severe organic phosphorus intoxication;blood cholinesterase;electrolute ??? 笔者对19例重度有机磷农药中毒患者的全血胆碱酯酶（CHE）、电解质指标进行动态监测，并与正常人对照，探讨其变化规律及临床意义。现将结果报告如下。 ??? 1? 对象与方法 ??? 1.1? 对象? 根据文献［1］标准进行诊断分级，19例重度有机磷农药中毒患者：男2例，女17例，年龄19～58岁，平均30.5岁。入院后即给予阿托品10 mg静推，后每隔5 min以相同剂量静推一次以使病人阿托品化，病情稳定后，每日给予阿托品60 mg静滴以维持病人阿托品化，同时给予解磷定0.4 g静滴。对照组47例来自健康体检者，年龄18～49岁，平均28.7岁。 ??? 1.2? 方法? 患者来院就诊时，采血1次，入院后第2、3、5、7日晨各采血1次，每次抽取静脉血4 ml，待血液凝固后，离心取血清，健康对照组来自正常体检人员。CHE采用速率法检测，为潍坊3 v生物工程有限公司产品。正常值：4300～10500 u/L，检测仪器为日立-7060型全自动生化分析仪；电解质检测采用北京尼泰克