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我们近年采用大剂量阿托品救治急性杀虫脒重度中毒病情凶险患者,疗效满意,现报告如下:临床资料 14例中男性5例、女性9例,17～54岁。均口服农药致急性重度中毒,病情凶险,伴有多脏器损害和功能衰竭。14例均呈深昏迷,明显发绀,休克。其中呼衰9例,急性心功能障碍肺水肿7例,心律失常6例(心动过缓4例),消化道出血4例,肾功能衰竭及中毒性肝炎各1例。治疗方法病例入院后除采用减少毒物吸收,彻底洗胃(5例因胃插管困难而行胃造瘘术洗胃);促进毒物排泄,大量输液,催吐,利尿;应用美蓝及大量维生素C;治疗各系统并发症等一般性治疗,并均采用大剂量阿托品治疗。据中毒程度,阿托品首次量20～40～80mg,以后依病情变化,每隔10～15～20分钟静推一次,直至“阿托品化”(即四肢转温,心率增快至100～120次/分,血压回升,神志意识转清,病情改善)逐渐减量。达阿托品化后24小时内全部停药,平均用量1026mg,最大用量为2360mg。治疗结果 14例均获痊愈。均于用药24小时内神志意识转清,皆无副作用。而我们在1987年前单用传
We use large doses of atropine in recent years, the treatment of acute chlordimeform severe poisoning in patients with malignant disease, the results are satisfactory, are as follows: Clinical data of 14 cases, 5 males and 9 females, 17 to 54 years old. All oral acute toxicity caused by pesticides, dangerous condition, accompanied by multiple organ damage and failure. 14 cases were deep coma, obviously cyanosis, shock. Among them, 9 cases of respiratory failure, 7 cases of acute cardiac dysfunction and pulmonary edema, 6 cases of arrhythmia (4 cases of bradycardia), 4 cases of gastrointestinal bleeding, 1 case of renal failure and toxic hepatitis. Treatment methods In addition to the use of reducing poison absorption after admission, complete gastric lavage (gastric biopsy in 5 cases of gastrostomy gastric lavage); promote toxic excretion, massive infusion, vomiting, diuretic; application of methylene blue and a large number of vitamin C ; Treatment of various systemic complications and other general treatment, and are treated with high-dose atropine. According to the degree of poisoning, atropine 20 ~ 40 ~ 80mg for the first time, after the change according to the condition, every 10 ~ 15 ~ 20 minutes to push the static until “atropine” (ie extremities temperature, heart rate increased to 100 to 120 times / Points, blood pressure rise, conscious consciousness to clear, the condition improved) tapering. Databasing all drugs within 24 hours after drugization, the average dosage of 1026mg, the maximum dosage of 2360mg. All 14 cases were cured. Within 24 hours of medication consciousness consciousness, no side effects. And we only pass before 1987