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呼吸肌麻痹是有机磷农药中毒的主要死因之一。其发生机理是由于胆碱酯酶活力下降,乙酰胆碱蓄积,神经肌肉传导先兴奋后抑制以致呼吸肌麻痹。1985至1986两年间,我院共收治口服有机磷农药重度中毒96例,有6例发生呼吸肌麻痹。其中女性5例,男性1例,年龄17～41岁,均在服毒后1小时内入院,并接受了常规排毒和解毒处理,分别于服毒后24～69小时发生呼吸肌麻痹。6例均行了气管切开术和简易呼吸器人工呼吸。死亡1例,治愈的5例中,自主呼吸停止的时间分别为7～20天,但无后遗症发生。抢救的成败与护理质量关系极大,现谈谈我们的体会。
Respiratory muscle paralysis is one of the main causes of organophosphorus pesticide poisoning. The mechanism is due to decreased cholinesterase activity, accumulation of acetylcholine, neuromuscular transmission after the first excitement and inhibition of respiratory muscle paralysis. Two years from 1985 to 1986, our hospital received a total of 96 cases of severe oral organophosphorus pesticide poisoning, respiratory muscle paralysis occurred in 6 cases. Among them, 5 were women and 1 was male, ranging in age from 17 to 41 years. All patients were admitted within 1 hour after taking the drug and accepted conventional detoxification and detoxification treatment. Respiratory muscle paralysis occurred 24 to 69 hours after taking the drug. Six patients underwent tracheotomy and simple respirator artificial respiration. 1 case of death, 5 cases of cure, spontaneous breathing stopped for 7 to 20 days, but no sequelae occurred. The success or failure of rescue and care quality is great, now talk about our experience.