急性有机磷农药中毒的急救与体会.docVIP

精品论文 参考文献 急性有机磷农药中毒的急救与体会 杨静 刘建坤 张舒（四川省宣汉县人民医院急诊科 四川宣汉 636150） 【中图分类号】R595.4【文献标识码】A【文章编号】1672-5085（2012）20-0023-02 【摘要】目的 探讨有机磷农药中毒的急救方法。方法 对我院急诊科治疗的急性有机磷农药中毒（AOPP）患者88例立即给予阿托品及胆碱酯复能剂、洗胃、更衣、吸氧、补液等，彻底清除毒物，保持呼吸道通畅，严密观察病情变化，正确区分是达到了阿托品化还是阿托品中毒，以及有机磷中毒反跳，尽早发现各种并发症的发生。结果 本组88例中76例治愈，2例发生迟发性多发性神经病，4例出现中间型综合征死亡，6例发生呼吸衰竭及多脏器衰竭死亡。结论 有机磷农药中毒要彻底清除毒物，掌握正确的洗胃方法，掌握阿托品及胆碱酯酶复能剂的正确合理应用，纠正电解质紊乱，保护重要脏器功能，对重度中毒及时血液透析和血液灌流，可提高抢救成功率。 【关键词】有机磷农药 中毒 急救 体会 The first aid and experience of organophosphorus pesticide poisoning 【Abstract】　Objective To discuss the first aid of organophosphorus pesticide poisoning.Methods Among 88 patients,they all were immediately given atropine and Cholinesterase Reactivators,made thoroughly gastric lavage,removed their clothes,given Oxygen,providedhydration and so on to remove toxins thoroghly and make sure every patientrsquo;s airway is open and it is easy to breathe.we keep an eye on the patients to distinguish among similarpHenomena,such as Maintain the efficacy of atropineand,atropine poisoning and organophosphorus pesticide poisoning bounce-back in order that we can find all sorts of complications as early as possible.Results Among 88 cases,76 cases were rescued successfully.2 cases appeared delayed polyneuropathy.4cases showed intermediate syndrome (IMS),and 6 cases died of respiratory failure and multiple organ failure (MOF).Conclusion To remove toxins,gastric lavage and using properly atropine and cholinesterase agents are the key to success in acute organophosphorus pesticide poisoning.As for severe poisoning patients,besides correcting electrolyte imbalances to proteCTimportant viscera functions,we should give them timelyhemodialysis andhemoperfusion to increase the rescue rate. 【Key words】　Organophosphorus pesticide Poisoning First-aid Experience 有机磷农药中毒是急诊科常见的急症之一，其病情危重多变，死亡率极高，救治要争分夺秒。同时密切观察病情变化，加强护理，预防并发症，保护重要脏器功能，这些是抢救有机磷农药中毒成功的关键。 1 资料与方法 1.1临床资料 2008年7月—2011年7月通过呼救“120”