急性重度有机磷农药中毒并发症的发生与毒物种类之间的相关性分析

摘要

目的 探讨口服有机磷农药急性重度中毒患者并发症的发生率及其与有机磷农药种类之间的关系.方法 收集2010年7月-2015年12月解放军第307医院急诊重症监护室(EICU)收治的167例口服有机磷农药急性重度中毒患者的病例资料,按照口服有机磷农药的种类不同分成三组,即甲拌磷中毒组(A组)、敌敌畏中毒组(B组)及乐果中毒组(C组),比较三组临床并发症的发生率的差异.结果 三组患者在呼吸心跳骤停、呼吸衰竭及脑水肿的发生率差异无统计学意义(P＞0.05);而口服敌敌畏急性重度中毒组的患者的死亡率,及并发急性循环衰竭、浆膜腔积液、低蛋白血症、血液浓缩等并发症的发生率显著高于口服甲拌磷急性重度中毒组和口服乐果急性重度中毒组,差异有统计学意义(P＜0.05).结论 口服敌敌畏中毒的急性重度患者与口服乐果急性重度中毒和口服甲拌磷急性重度中毒的患者相比,易发生循环衰竭、浆膜腔积液、低蛋白血症、血液浓缩等并发症,而且死亡率也显著高于另外两组患者.口服敌敌畏急性重度中毒组患者在循环衰竭的基础上容易发生浆膜腔积液、低蛋白血症、血液浓缩等并发症,考虑可能与毛细血管渗漏综合症有关.%Objective To explore the incidence of complications of acute severe organophosphorus pesticide poisoning and the relationship between the incidence and different kinds of organophosphorus pesticide.Methods Clinic data of acute severe organophosphorus pesticide poisoning(SAOPP) treated in the emergency intensive care unit(EICU) of 307 hospital from July 2010 to December 2015 were collected.167 SAOPP patients were divided into three groups:acute severe phorate poisoning group (Group A),acute severe dichlorvos poisoning group (Group B) and acute severe dimethoate poisoning group (Group C).And the incidence of complications among the three groups were compared.Results There were no significant difference in the incidence of respiratory cardiac arrest,respiratory failure and cerebral edema among the three groups (P＞ 0.05),while the mortality of acute severe oral dichlorvos poisoning group,moreover,the incidence of acute circulatory failure,serious cavity effusion,hypoalbuminemia and blood concentration in acute severe oral dichlorvos poisoning group were significantly higher than those of the other two groups (P ＜ 0.05).Conclusion Circulatory failure were more likely to happen in patients with acute severe oral dichlorvos poisoning than the others,so as the severe mortality.Capillary leak syndrome may be the culprit.