基层医生对急性有机磷农药中毒的不当治疗分析

目的:深入探讨了基层医生在对急性有机磷农药中毒治疗过程中所采用的不当治疗方式进行了深入的分析。方法:对某省不同基层医院在一个长期时间段内所治疗的500例急性有机磷农药中毒患者资料进行了分析,对其中所存在的不合理治疗进行了总结并分析导致的原因。结果:基层医生对急性机磷农药中毒的不当治疗主要表现为毒物清除不彻底;胆碱酯酶复能剂应用途径不恰当;阿托品剂量应用或停药时间不当;治疗过程中应用了一些抑制胆碱酯酶活性的药物;呼衰病人呼吸机的使用时机和方法不当。其产生的主要原因是医生对病人病情的错误判断和对某些影响急性有机磷农药中毒治疗疗效的相关因素缺乏了解。结论:正确判断病情是避免不当治疗的关键。     

有机磷农药中毒的护理

随着有机磷农药使用范围的日益广泛 ,在农村、有机磷农药中毒仍居各种急性中毒的首位。尤其重度有机磷中毒 ,病情凶险死亡率高。在抢救此类患者中 ,良好的护理无疑是提高治愈率的重要保证。因此 ,护理工作者应密切观察病情 ,切实加强护理 ,及时发现和预防各种并发症 ,才能使患者转危为安。1　临床表现1 .1　毒蕈硷样症状患者瞳孔缩小 ,严重者小似针尖 ,晚期则瞳孔散大 ,对光反射消失 ,由于支气管痉挛 ,分泌物增加 ,可引起呼吸困难 ,严重者可发生急性肺水肿 ,粉红色泡沫状分泌物不断从口鼻溢出 ,造成缺氧 ,末梢发酣 ,甚至导致呼吸衰竭。由于…     

急性重症有机磷农药中毒的综合救治(附42例分析)

1,临床资料1.1,一般资料42例中男15例,女27例,平均年龄32.2岁(16～70岁),从表1中可以看出,死亡组年龄偏大,就诊时间长,与存活组有显著差异。表1中毒预后与年龄、就诊时间比较1.2,农药种类与预后42例全部经口服中毒,服毒量100～500ml;在死亡9例中,对硫磷(1605)3例,占42.1%(3/7);敌敌畏2例,占20%(2/10);甲胺磷1例,占10%1/10);乐果2例,占25%(2/8);氧化乐果1例,占16.7%(1/6)。1.3,临床表现诊断按文献标准。符合重度有机磷中毒的表现,其中25例昏迷。呼吸衰竭15例,肺水肿11例,休克2例。胆碱酯酶活性均<30%。1.4,治疗情况:1.4.1,洗胃及导泻所有患者…     

高原急性有机磷农药中毒64例临床分析

目的研究高原有机磷农药中毒诊断及抢救方案。方法对64例患者临床救治进行回顾分析。结果基本掌握临床救治。结论掌握高原有机磷农药中毒诊断及抢救治疗措施,呼吁社会各界加大有机磷农药的监管力度,减少急性中毒事故的发生。     

急性有机磷农药中毒中间综合征1例

急性有机磷农药中毒在救治过程中，由于有机磷可贮存在组织中释放人血，故症状反复病情恶化，临床上俗称“有机磷中毒反跳”，现在早已被人们重视，但出现中间综合征较少见，发病率约7％左右，可能由于临床经验不足把中间综合征误诊为“反跳”，而贻误了抢救机会。我院2003年6月，急诊收治急性有机磷农药中毒中间综合征一例，现报告如下：     

畜禽有机磷农药中毒的诊断与治疗

本文分析了通过畜禽有机磷农药中毒的临床症状,得出诊断结果和治疗方法.针对具体致病原因和病理变化,论述了几种有效的治疗方法及预防措施.     

有机磷农药中毒治疗体会

在急诊及住院的抢救病人中,急性中毒者占很大的比例,其中又以有机磷农药中毒者为多,特别是乡、区级医院。有机磷农药中毒,起病急、发展快、病情重,如不及时诊断,积极抢救,常危及病人生命,现将救治过的有机磷农药中毒病人分析总结。     

Genetic Polymorphism of Angiotensin II Type 1 Receptors and Their Effect on the Clinical Outcome of Captopril Treatment in Arab Iraqi Patients with Acute Coronary Syndrome (Mid Euphrates)

Genetic variation in the angiotensin II type 1 receptor (AT1R) has an important effect on the outcome of acute coronary syndrome (ACS) initiated treatment with captopril. This study aims to investigate the impact of genetic polymorphism of AT1R (rs5186 and rs275651) on the ACS outcome in Iraqi patients treated with captopril. A total of 250 Iraqi individuals with ACS were included in this case—control study and they were divided into two study groups; Study group 1 included 125 participants who were prescribed captopril, 25 mg twice daily and study group 2 included 125 participants who received no captopril as part of their ACS treatment (control study). The AT1R gene (rs5186) CC genotype was found to be associated with ST-elevation myocardial infarction (STEMI) (Odd’s ratio (O.R) = 1.2, P = 0.7), while AC was associated with Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina (UA) (O.R = 1.2, P = 0.8). AC genotype is more prone to have Percutaneous coronary intervention (PCI) after ACS attack (O.R = 1.2, P = 0.6). CC genotype had a risk to get less improvement (O.R = 1.6, P = 0.5), so might require higher doses of captopril during acute coronary insult. The AT1R gene (rs275651) AA genotype was associated with UA (O.R = 1.3, P = 0.9). AA and AT genotypes were more prone to have PCI after ACS attack (O.R = 3.9 P = 0.2, O.R = 3.5, P = 0.3 respectively) and thus requiring higher doses of captopril. We conclude that the AT1R rs5186, rs275651 genetic polymorphisms might partially affect the clinical outcome of ACS patients treated with captopril and might have captopril resistance which requires higher doses.