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急性有机磷中毒常可并发精神障碍,而引起神经病变者罕见。兹就我院所见一例,报告如下。 患者女,30岁,于1987年3月30日口服DDV30ml,10分钟后口吐白沫,遂即昏迷来诊。查体:T36.7℃ P70次/分,R25次/分,BP130/90mmHg,浅昏迷,面色紫红,呼吸急促,全身大汗及轻微肌束震颤,双侧瞳孔针尖大小,光反射迟钝,双肺底可闻中小水泡音,心音低钝,节律整齐,经洗胃、导泻、补液、利尿及应用解磷定,大量阿托品后一周痊愈。但因吸入性肺炎继续抗炎治疗。于第三周开始述双下肢沉重、乏力,肌肉疼痛,并逐渐加重伴麻木感,阵发性上肢肌肉抽搐,进而感双上肢无力,不能抬举,提轻物不起。站立时须双手扶床或须持杖,双足呈“反八字”,行走时缓慢移动。
Acute organophosphate poisoning can often be complicated by mental disorders, while those who cause neuropathy is rare. I see an example of hospital, the report is as follows. Female, 30 years old, on March 30, 1987 oral DDV30ml, foaming at the mouth after 10 minutes, then the coma to the clinic. Physical examination: T36.7 ℃ P70 beats / min, R25 beats / min, BP130 / 90mmHg, light coma, purple face, shortness of breath, sweating and mild muscle bundle tremor, bilateral pupil needle size, light reflex, The end of the lung can be heard small blisters sound, heart sounds low blunt, rhythm, gastric lavage, catharsis, rehydration, diuresis and application of phosphate solution, a large number of atropine recovered after a week. However, aspiration pneumonia to continue anti-inflammatory treatment. In the third week began to describe the double lower extremities heavy, fatigue, muscle pain, and gradually with a sense of numbness, paroxysmal upper limb muscle twitching, and then sense of upper extremity weakness, can not lift, reduce the material can not afford. When standing with both hands to bed or to be a stick, feet were “anti-character,” walking slowly move.