CAJ | 학술논문

目的：探讨急性有机磷农药中毒（AOPP）现状，完善AOPP的防治工作，降低AOPP患者的病死率。方法对400例AOPP患者的发病时间、性别、年龄、就诊时间、中毒类型、临床表现、呼吸肌麻痹（RMP）的发生率、病死率、入院时的血清胆碱脂酶（ChE）、阿托品的用量进行统计分析。结果使用性中毒患者中男性占82.30%（P<0.01）。使用性中毒和食物中毒的患者中重型临床表现例数较少（P<0.01）。口服中毒者的病死率（22.27%）、RMP发生率（43.36%）；阿托品维持量（50.0mg）、阿托品总量（836.0mg）；恢复至口服维持的时间（9.3d）较长，与其他两种有显著性差异（P<0.01）。使用性中毒患者的就诊时间（29.1h）较晚（P<0.05）。随年龄增大、病死率有上升趋势。结论使用性中毒发病率有逐渐下降趋势，其阿托品用量少、恢复快、RMP的发生率和病死率低。需加强有机磷农药的管理，限制剧毒高毒类农药的生产、销售和使用。入院时的血清胆碱脂酶值与病情及预后不相关。在治疗上要根据不同的类型中毒和临床表现选择合适的治疗方案，降低病死率。
목적：탐토급성유궤린농약중독（AOPP）현상，완선AOPP적방치공작，강저AOPP환자적병사솔。방법대400례AOPP환자적발병시간、성별、년령、취진시간、중독류형、림상표현、호흡기마비（RMP）적발생솔、병사솔、입원시적혈청담감지매（ChE）、아탁품적용량진행통계분석。결과사용성중독환자중남성점82.30%（P<0.01）。사용성중독화식물중독적환자중중형림상표현례수교소（P<0.01）。구복중독자적병사솔（22.27%）、RMP발생솔（43.36%）；아탁품유지량（50.0mg）、아탁품총량（836.0mg）；회복지구복유지적시간（9.3d）교장，여기타량충유현저성차이（P<0.01）。사용성중독환자적취진시간（29.1h）교만（P<0.05）。수년령증대、병사솔유상승추세。결론사용성중독발병솔유축점하강추세，기아탁품용량소、회복쾌、RMP적발생솔화병사솔저。수가강유궤린농약적관리，한제극독고독류농약적생산、소수화사용。입원시적혈청담감지매치여병정급예후불상관。재치료상요근거불동적류형중독화림상표현선택합괄적치료방안，강저병사솔。
ObjectiveTo decrease the mortality of the acute organophosphorus pesticide poisoning(AOPP)and improve the preventment and therapy of it by investigating AOPP in the countryside region.MethodsA retrospective review was conducted about the difference of episode time, sex,age,time of medical treatment,type of intoxication,clinical situation,incidence rate of respiratory muscular paralysis(RMP),mortality, prior to admission of serum cholinesterase,atropinic dosage of 400 patients.ResultsThe rate of used poisoning in male is 82.30%.The case of middle and gravis type are few which poisoned by used or food poisoning,the mortality(22.27%),the incidencerate of RMP(43.36%),the maintenance dose of atropine(50.0mg),the total amount of atropine(836.0mg)were higher and the time of recover to maintaining by mouth was longer than the other two groups,the difference was signifi cant(P<0.01). The poisoned patients of using AOPP were send to hospital lately(P<0.05). The mortality rate rose in older patients.Conclusions Intoxicated patients because of using phosphate pesticide are fewer in recent year,need lower dosage of Atropine,recovery quickly and have lower incidence rate of RMP and mortality. More attention must be paid to enhance the management and restrict the producing,selling and using of phosphate pesticide.in order to decrease disease incidence of AOPP.The prior to admission of serum cholinesterase is not related with state of an illness and prognosis.We must choose proper therapeutic regimen in accordance with different route of intoxication and clinical situation to decrease mortality .