血液灌流救治有机磷农药中毒26例疗效观察

目的观察血液灌流在救治有机磷农药中毒中的作用。方法对26例有机磷中毒患者作为治疗组,在传统治疗基础上应用血液灌流观察临床疗效,并与过去常规治疗的30例有机磷中毒病例作对比分析。结果治疗组治愈率84．6％,对照组治愈率46．7％。治疗组抢救成功率明显优于对照组。结论有机磷中毒患者应用血液灌流,可提高抢救成功率,治愈率,缩短患者住院日,减轻病人的经济负担,具有重要意义。     

血液灌流对急性重度有机磷中毒患者血清酶学变化的影响

目的探讨血液灌流在急性重度有机磷中毒患者合并血清酶学改变的临床意义。方法选取急性重度有机磷中毒患者43例,于入院后6h,血液灌流后24h分别采血,行LDH、CK、CK-MB、AST、CHE检测,并与相同例数的非有机磷中毒体检健康患者相比较。结果急性重度有机磷中毒患者血清酶学有显著改变,行血液灌流后其血清酶学均有不同程度改善。结论血液灌流可迅速改善急性重度有机磷中毒患者的症状,减少并发症的发生,减低其对心肌等重要器官的损害,值得临床进一步探讨。     

血液灌流抢救急性重症有机磷农药中毒的临床研究

目的观察血液灌流抢救急性重症有机磷农药中毒的疗效。方法对49例重症有机磷农药中毒患者,随机分为灌流组25例,非灌流组24例,灌流组在常规洗胃、阿托品、碘解磷定、复能剂和脱水等治疗的基础上,采用血液灌流治疗,并对其结果进行分析。结果血液灌流组治愈23例,治愈率92.0%,非灌流组治愈16例,治愈率66.7%,两组治愈率相比有显著性差异(P<0.05)。灌流组减少了阿托品用量,缩短了昏迷清醒时间、胆碱酯酶恢复及机械通气时间,缩短了平均住院日,与非灌流组相比,两组有显著差异(P<0.05)。结论血液灌流是救治重度有机磷农药中毒的有效方法。     

床旁血液灌流治疗重度有机磷农药中毒的临床观察

目的研究床旁血液灌流治疗重度急性有机磷农药中毒（AOPP）的效果。方法对在常规内科治疗上加用床旁血液灌流治疗（治疗组）的23例急性重度有机磷农药中毒患者的临床资料进行回顾性分析,并以24例（对照组）采用常规内科治疗的病例作对照。结果治疗组和对照组比较,患者昏迷至清醒时间、胆碱酯酶活力恢复时间、住院时间明显缩短,中间综合征发生率下降,应用阿托品总量减少（P均〈0.01）,病死率降低（P〈0.05）。结论血液灌流能迅速清除体内毒物,提高急性重度有机磷农药中毒患者抢救成功率。     

血液灌流治疗急性重度有机磷农药中毒的疗效观察

急性有机磷农药中毒是临床上常见的急症,特别是重症病例病死率可达8.5%~58.6%。2006年1月至2010年6月我院应用血液灌流(HP)方法治疗重度有机磷农药中毒34例收到良好效果,现将结果报道如下:1资料与方法1.1一般资料:本组研究设置两组资料进行对照观     

床旁血液灌流抢救急性重度有机磷中毒的疗效观察

目的:观察血液灌流抢救急性重度有机磷农药中毒的疗效.方法:将2005-08～2009-05收治的57例重度有机磷农药中毒患者随机分为对照组和治疗组,治疗组在常规内科治疗的基础上加用血液灌流(HP),对照组单纯行常规内科治疗.观察对照两组病例的治愈率、阿托品总用量、昏迷时间、住院天数.结果:治疗组阿托品总用量减少(t=4.092,P＜0.01),患者昏迷时间缩短(t=3.24,P＜0.01),住院天数缩短(t=4.505,P＜0.01),治愈率提高(χ2=4.073,P＜0.05).结论:对于重度有机磷农药中毒患者,除内科常规治疗外加用血液灌流.     

规范化急救联合早期血液灌流对急性重度有机磷中毒患者救治效果

目的探讨规范化急救联合早期血液灌流对急性重度有机磷中毒患者的救治效果。方法选取自2012年1月至2018年1月在沈阳急救中心接受治疗的90例急性重度有机磷中毒患者为研究对象。按照治疗方法的不同将患者分为常规组与观察组,每组各45例。常规组患者进行早期血液灌流,观察组患者进行规范化急救联合早期血液灌流。治疗后,比较两组患者的并发症发生率及对急救措施的满意程度。结果观察组患者并发症发生率为8.9%(4/45),低于常规组的48.9%(22/45),组间比较,差异有统计学意义(P<0.05)。观察组患者的总满意率为80.0%(36/45),高于常规组的42.2%(19/45),组间比较,差异有统计学意义(P<0.05)。结论采用规范化急救联合早期血液灌流对急性重度有机磷中毒患者的救治效果良好。     

血液灌流治疗重度有机磷农药中毒疗效观察

目的 探讨血液灌流治疗重度有机磷农药中毒的临床疗效.方法 按入院的先后顺序,82例重度有机磷农药中毒患者被随机分为观察与对照两组（n=41）.对照组给予常规治疗,观察组在常规治疗的基础上加用血液灌流治疗.观察比较两组患者的各项疗效指标.结果 观察组的治愈率（90.2%）高于对照组（70.7%）,而并发症发生率为2.4%,低于对照组的14.6%（P＜0.05）;阿托品和解磷定总用量为（345.8±40.5）mg和（14.2±1.9）g,均少于对照组的（583.2±45.7）mg和（25.4±3.5）g;住院时间为（8.2±1.7）d,短于对照组的（11.2±1.8）d（P＜0.01）.结论 血液灌流可以明显提高重度有机磷农药中毒患者的治愈率,降低并发症发生率,是抢救重度有机磷农药中毒的有效措施.     

床旁血液灌流抢救急性重度有机磷中毒的疗效观察

目的：观察血液灌流抢救急性重度有机磷农药中毒的疗效。方法：将2005-08—2009-05收治的57例重度有机磷农药中毒患者随机分为对照组和治疗组,治疗组在常规内科治疗的基础上加用血液灌流（HP）,对照组单纯行常规内科治疗。观察对照两组病例的治愈率、阿托品总用量、昏迷时间、住院天数。结果：治疗组阿托品总用量减少（t=4．092,P〈0．01）,患者昏迷时间缩短（t=3．24,P〈0．01）,住院天数缩短（t=4．505,P〈0．01）,治愈率提高（X2=4．073,P〈0．05）。结论：对于重度有机磷农药中毒患者,除内科常规治疗外加用血液灌流。     

对于危急重症有机磷中毒患者的临床急救分析

目的：分析研究危急重症有机磷中毒患者的临床急救措施。方法选取在本院治疗危急重症有机磷中毒患者80例,将80例患者平均分成两组,其中一组为对照组,采取常规的急救方法,另一组为观察组,在采取常规急救的方法的同时予以血液灌流对患者进行治疗,观察比较两组患者的临床急救效果。结果观察比较两组患者,观察组治疗后总有效率高于对照组,差异有统计学意义,P＜0.05。结论对于危及重症有机磷中毒急救采取血液灌流的方法在临床上治疗效果更好,治疗时间短,患者病情恢复快,适合临床的广泛使用。     

长托宁对有机磷中毒伴中枢神经系统损害的疗效观察

目的分析长托宁在急性有机磷农药中毒伴中枢神经系统损害中的应用疗效。方法选择应用长托宁治疗的重度急性有机磷农药中毒伴中枢神经系统损害患者48例作为治疗组,并将过去使用阿托品治疗的重度有机磷农药中毒伴神经系统损害的43例既往病例作为对照组进行对比,比较两组的中毒症状持续时间、不良反应、胆碱酶活力恢复情况及治愈率。结果治疗组较对照组M样症状及中枢神经症状消失时间明显缩短,平均用药次数及用药量明显减少,并发症发生率与病死率明显降低。结论长托宁治疗重度有机磷农药中毒伴中枢神经系统损害较阿托品疗效好,不良反应发生率低。     

新合成抗胆碱药物的筛选

本文报道了抗胆碱化合物的综合筛选方法和部分化合物的初筛结果。在五个指标上,测定化合物效应的ED_(50)值,即抗槟榔碱震颤和唾液分泌、预防PP_(10)中毒、扩瞳效应和影响小鼠跳杆训练。分析比较这些结果,可以确定化合物的抗胆碱性质、作用强度、中枢和外周作用的选择性、预防OP_(10)中毒效价和预测副作用的大小。列入本文的化合物评选结果可见:大部分化合物的中枢和外周抗胆碱作用强度相当,小部分化合物的中枢抗胆碱作用较强或外周抗胆碱作用较强。这些结果为进一步评选打下基础。文中讨论了筛选指标的选择问题。     

What may be happen after an organophosphate exposure: Acute myocardial infarction?

The increase in accidental organophosphate poisoning as well as the rise in the number of cases of suicide attempts with organophosphate compounds is due to primarily to the widespread use of these compounds in agriculture. Organophosphates are anti-acetycholinesterase agents and their toxicity affects many organs, including the pancreas, liver and heart. Cardiac complications often accompany poisoning with these compounds and may be serious and often fatal. However, little is known about the myocardial infarction risk associated with exposure to pesticides. Herein, a rare case of acute myocardial infarction due to acute exposure to organophosphate compound is documented with electrocardiogram, enzyme and clinical characteristics in this report.     

有机磷中毒性脑病恢复期MRI表现(附4例报告)

目的:探讨有机磷中毒性脑病恢复期的MRI特征.方法:回顾性分析4例重度有机磷中毒慢性期脑结构变化.结果:双侧巴宾斯基征阳性4例,脑电图轻度异常4例.1例右侧小脑半球和中脑长T1长T2信号.1例双侧尾状核和壳核对称性长T2信号,T1WI高信号.1例双侧尾状核、壳核和苍白球对称性长T1长T2信号,侧脑室扩大,小脑萎缩.1例双侧尾状核、壳核和苍白球对称性异常信号,T1WI部分萎缩的小脑回呈高信号;脑室扩大,双侧枕叶内侧回、脑干和小脑萎缩.结论:有机磷中毒性脑病恢复期MRI表现主要累及尾状核、苍白球、丘脑、中脑和小脑;严重者皮质出现软化灶,伴有脑萎缩.     

结肠治疗机治疗重度有机磷农药中毒临床观察

目的探讨结肠治疗机配合常规方法治疗重度有机磷农药中毒的临床疗效。方法选择122例重度有机磷农药中毒患者。其中治疗组68例,对照组54例。两组均按照常规抢救方法进行抢救,另外对照组用25%硫酸镁250 m l或20%甘露醇250 m l,于洗胃末由胃管注入进行导泻,治疗组则给予用CTJ-A结肠灌注透析治疗机灌注治疗,并予我院自制的100 m l复方黄连灌肠液保留灌肠。结果两组相比在治愈率、治愈时间、阿托品用量、住院天数、出现中间综合征、反跳例数上均有显著差异。结论使用结肠治疗机配合常规方法治疗重度有机磷中毒可以缩短抢救时间,提高抢救成功率,减少阿托品用量,缩短病程,减少患者的痛苦和经济负担。     

Study on the specificity of fibronectin for post-mortem diagnosis of early myocardial infarction

In order to investigate the specificity of fibronectin (Fn) in the post-mortem diagnosis of myocardial infarction, the changes of Fn staining in normal, infarcted and other non-infarcted myocardial injuries resulting from myocarditis, mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion and organophosphate poisoning were studied with an immunohistochemistry and image analysis system. The results showed that positive Fn staining could only be observed in groups of myocardial infarction and myocarditis, but could not be found in groups of mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion, and organophosphate poisoning. Our findings indicate that positive staining of Fn in cardiomyocytes could be affected only by myocarditis, so it is quite specific for the diagnosis of myocardial infarction.     

A profile of acute poisoning at Mangalore (South India)

BACKGROUND: The aim of this study was to characterize the poisoning cases admitted to the Government Wenlock Hospital (a teaching hospital of Kasturba Medical College) Mangalore, India. STUDY DESIGN: All cases admitted to the emergency department of the hospital between January 2001 to May 2003 evaluated retrospectively. Data obtained from the hospital medical records and included the following factors: socio-demographic characteristics, agents and route of intake, and time of admission of the acutely poisoned patients. RESULTS: Of the total 33,207 patients admitted in the hospital for treatment, 325 patients were for to acute poisoning. This was 1% of all emergency admissions. Of these 70% were males and 30% females. The majority (36%) cases were from age group of 21-30 years. Most (72%) poisonings were intentional and only 27% were unintentional. The most important agents of acute poisoning were agrochemical pesticides (49%) followed by drugs (17%), and alcohols (13%). Forty-eight (15%) patients died. The poisons responsible for most of the mortality were organophosphate pesticides (65%) and aluminium phosphide (15%). In summary, the prevention and treatment of poisoning due to organophosphate and aluminium phosphide should merit high priority in the health care of the indigenous population of South India (Dakshina Kannada district).     

A fatal case of poisoning by fenitrothion without evidence of chemical exposure

We describe a mysterious fatal case of poisoning by fenitrothion of a male adult. No typical external signs of organophosphate poisoning were found; we observed patchy mucosal hemorrhages of the bronchi and slight parenchymal hemorrhages of the lower lobe of the left lung at autopsy. The stomach contained 10 g of a faintly purplish/reddish viscous fluid with no chemical smell. Gas chromatography and gas chromatography-mass spectrometry analyses of blood specimens revealed substantial amounts of fenitrothion. The concentrations in cerebrospinal fluid, vitreous humor, and urine are also presented. We concluded that the victim probably died of delayed respiratory insufficiency caused by acute fenitrothion poisoning.     

Prolonged cholinergic crisis and compartment syndrome following subcutaneous injection of an organophosphate compound for suicide attempt

A case of poisoning with highly lipid soluble organophosphate compound, fenthion is reported in which cholinergic crisis recurred upto 25 days following a suicide attempt. Subcutaneous injection of fenthion in the antecubital fossa by the patient produced massive swelling, cellulitis and compartment syndrome of the left arm. Emergency fasciotomy helped in restoration of circulation and saved the limb from being amputated.     

Toxicoepidemiology of fatal poisonings in Southern India

An autopsy based retrospective study was conducted from January 2000 to December 2006 at Manipal in Southern India, and a profile of the victims of poisoning was prepared. The study was done to understand the magnitude and pattern of all poisoning fatalities in relation to the manner of death in Manipal region of Southern India. The study included a total of 198 cases of fatal poisoning. Self-poisoning was reported in 92.9% cases. Fatal accidental poisoning was seen in 6.1% cases. Homicide by poisoning was not reported during the study period. Uncertainty regarding the manner of death due to poisoning was observed only in two cases. Males were predominantly affected (71.2%). The majority of the victims were in the 3rd decade (28.3%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. While majority of the victims consumed poison during daytime, most of the poisoning fatalities were reported during summer months. Organophosphate compounds were implicated in 68.7% of the total poisoning related fatalities. Males in the 3rd to 5th decades were prone to self-poisoning with organophosphate compounds. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of epidemiology of poisoning in our region.