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目的探讨急性有机磷农药中毒(AOPP)患者中间综合征(IMS)的发生率、病死率和危险因素。方法回顾1999年1月至2004年5月ICU收治的226例AOPP患者的临床资料,并将患者分为IMS组和非IMS组,以前向Wald概率似然比统计法多元Logistic回归分析确定IMS的独立危险因素。结果362例AOPP患者,确诊IMS68例,IMS的发生率为18．78%(68/362)；AOPP死亡14例,其中IMS 7例,IMS病死率为10．29%(7/68),AOPP病死率为3．87%(14/362)。中毒农药种类、中毒量、中毒途径、抬头困难、肌颤、复能剂、血白细胞数、动脉血氧分压、二氧化碳分压及血钾与IMS有关,Logistic回归分析提示抬头困难、血白细胞增高、二氧化碳分压增高的相对危险度及其95%可信区间分别为6．345(2．290～17．576),1．127(1．046～1．215),1．078(1．043～1．115)。结论抬头困难、血白细胞增高、二氧化碳分压增高是IMS的独立危险因素。
Objective To investigate the incidence, mortality and risk factors of intermediate syndrome (IMS) in patients with acute organophosphorus pesticide poisoning (AOPP). Methods The clinical data of 226 patients with AOPP admitted to the ICU from January 1999 to May 2004 were retrospectively analyzed. The patients were divided into IMS group and non-IMS group. Previously, multiple logistic regression analysis was used to determine the IMS Independent risk factors. Results A total of 362 patients with AOPP were diagnosed with IMS and 68 were diagnosed with IMS. The incidence of IMS was 18.78% (68/362). AOPP was also found in 14 patients, of which 7 were IMS and 10.29% (7/68) Case fatality rate was 3.87% (14/362). Poisoning poisoning types, poisoning, poisoning pathways, head-lifting difficulties, muscle flutter, energy agents, white blood cell count, arterial partial pressure of oxygen, partial pressure of carbon dioxide and serum potassium were associated with IMS. Logistic regression analysis showed that it was difficult to raise head and blood leukocytes , The relative risk of increased partial pressure of carbon dioxide and their 95% confidence intervals were 6.345 (2.290 ~ 17.576), 1.127 (1.046 ~ 1.215) and 1.078 (1) respectively. 043 ~ 1.115). Conclusion It is difficult to raise the head, blood leukocytes increased, carbon dioxide partial pressure is an independent risk factor for IMS.