high-dose treatment penehyclidine hydrochloride organophosphorus pesticide poisoning one case（大剂量盐酸penehyclidine治疗有机磷农药中毒1例）.docVIP

High-dose treatment penehyclidine hydrochloride organophosphorus pesticide poisoning one case I AOPP hospital emergency department treated each year the number of cases many, the routine use Changtuoning, pralidoxime chloride, gastric lavage, catharsis, oxygen, dehydration, diuretic, cardiac maintain airway patency, if necessary, mechanical ventilation, monitoring, maintenance water and electrolyte balance and other treatment, were cured Changtuoning dosage is generally 12 mg or less, the cases amounted to 36, mg (36 pieces) is rare, are reported below. A medical record patient, female, 49 years old, self-serving dichlorvos (DDVP) about 100 ml in at 10:00 on October 3, 2007 in our hospital emergency department. 1 h before admission, patients with oral administration after an argument with her husband about 100 DDVP ml, nausea, not vomiting, give soapy water immediately after family members found gavage, vomiting and gastric juice into the food. immediately call 120 sent to hospital after diagnosis given Changtuoning 4 mg, pralidoxime chloride 2.5 g, vitamin B1 , 200 mg intramuscular injection, warm water gastric lavage, activated charcoal + magnesium sulfate catharsis, establishment of intravenous access, oxygen, guardianship, diuretic treatment. Admission examination: T 6 ℃, P 14 times / min, R 28 times / min, BP 100/60 mmHg, SPO2 95%, unconsciousness, body clammy skin, sweating, two pupils and other large and round about 0.1 cm, pale, lips cyanosis, respiratory and vomit have a strong smell of pesticides, there are a lot of mouth secretions, chest and limbs visible muscle trembling, shortness of breath shallow, 28 beats / min, lungs could be heard and extensive small moist rales, HR 114 beats / min, heart sounds strong, law Qi, abdomen (-), fingernails bed cyanosis, physiological reflex, pathological reflex was not elicited. Whole blood CHE activity 20%, WBC 14.8 ?109 / L, N 84.6%, RBC 3.20 ?1012 / L, urine (-) liver function and electrolyte (-), BUN 5.0 m