重症杀灭菊酯、1605混合中毒1例报告

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杀灭菊酯又名速灭杀丁、速灭菊酯、戌酸氰酯、敌虫菊酯.属拟除虫菊酯类杀虫剂.其中毒病例报告不多.若本药与有机磷农药混合使用,则因有机磷抑制拟除虫菊酯在体内的水解而增强其毒性,病势凶险,现将我科收治的杀灭菊酯、1605混合中毒1例报告如下:一、病例介绍患儿男,4岁,主因腹痛伴频吐3小时急诊入院.入院前20小时病儿曾在吃饭时用手触摸装有杀灭菊酯、1605农药混合液的喷雾器,入院前4小时其父又在屋内用烯释成5%的杀灭菊酯农药喷撒灭蚊,1小时后病儿思睡.不时腹痛、频吐而急诊入院。查体:一般情况差,T36.7℃,P200次,R36次,血压85/55。呼吸困难,意识朦胧,全身皮肤发冷,颜面及指趾端明显发绀,甲床充盈欠佳。瞳孔缩小如小米粒大,等大等圆,光反应迟钝。鼻扇,唇绀,口腔分秘物多.颈软.双肺密布痰鸣及喘鸣音,可见三凹征,心音极低钝。腹不胀,肝肋下0.5cm.四肢肌张力增强并可见肌震颤,神经系统无异常.实验室检查:血K4,Na137,Cl 100(均为mEq/L);CO_2CP25vol%;心电图显示各导联ST 段均下降 Pyrethrins, also known as speed kill K, Chrysanthemum ester, Xu acid cyanide, pyrethrins. Pyrethroids are pyrethroid insecticides. The poisoning case report is not much. If the drug mixed with organophosphate pesticides Use, then due to organic phosphorus inhibition of pyrethroid hydrolysis in the body and enhance its toxicity, the risk of dangerous, now our department treated fenvalerate, 1605 mixed poisoning reported as follows: First, the case of children male, 4 Years old, the main due to abdominal pain with frequent vomiting 3 hours emergency admission.Patients 20 hours before admission sick children had dinner touch with the fenvalerate, 1605 pesticide mixture of the sprayer, 4 hours before admission, his father and house with ene Release 5% of fenvalerate pesticide spray mosquito control, 1 hour sick children sleepless nights. From time to time abdominal pain, frequency spit and emergency admission. Physical examination: poor general condition, T36.7 ℃, P200 times, R36 times, blood pressure 85/55. Dyspnea, dim-mindedness, chills on the whole body, clear cyanosis on the face and the toe, poor filling of the nail bed. Pupil narrowing such as millet grain, such as large circle, light reaction slow. Nasal fan, cyanotic lips, oral secretions and more. Neck soft. Two lungs dense sputum and wheezing, we can see three concave sign, low heart sound blunt. Abdominal distension, liver ribs 0.5cm. Limb muscle tension and visible muscle tremors, no abnormalities in the nervous system. Laboratory tests: blood K4, Na137, Cl100 (all mEq / L); CO_2CP25vol%; ECG showed that the guide ST segment are down
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