Severe organophosphate poisoning complicated with

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Severe organophosphate poisoning complicated by multiple organ failure clinical analysis of 66 cases

【Abstract】 Objective severe organophosphorus pesticide poisoning complicated by multiple organ failure in the pathogenesis and treatment experience. Methods Retrospective analysis of 66 patients with severe organophosphate poisoning complicated by multiple organ failure in patients with clinical data. Results All patients were within 24 h onset, involving the most is the brain and respiratory system. Conclusion of multiple organ failure is a common complication of organophosphorus poisoning and the leading cause of death, a reasonable strategy for an integrated treatment is to reduce the mortality of the key. Key words organophosphate poisoning; multiple organ failure; treatment of Chinese papers League finishing. multiple organ failure is the heart, brain, lung, liver, gastrointestinal tract and other vital organs or systems, there are two or more simultaneously or one after another failure, often occurs in severe clinical infection, shock, severe trauma, acute poisoning and so on later. Multiple organ failure is the emergency medical field is one important problem solved, because the domestic cities organophosphate poisoning patients less than the primary hospital, so the organic phosphorus poisoning of multiple organ failure are not many, are based on 1991 on July 1 ~ July 1, 2006 of organophosphorus poisoning our rescue multiple organ failure, the clinical features of 66 cases were analyzed as follows. 1 Materials and methods 1.1 General Information 1.1.1 Gender and age of 20 males and 46 females, aged 25 to 70 years, an average of 40 years old. 1.1.2 types of dichlorvos poisoning in 12 cases, 40 cases of dimethoate, phorate 14. 1.1.3 Oral drugs are toxic dose, 50 ml the following 30 cases, 50 ~ 100 ml 36 cases. 1.2 hours after taking the admission of 30 cases within 30 min,[link widoczny dla zalogowanych], 1 h in 20 cases, 1 ~ 3 h in 16 cases. 1.3 degrees of poisoning by toxic dose, clinical symptoms and reduce the level of cholinesterase activity classification, moderate in 32 cases, 34 cases of severe poisoning. 1.4 prior history of unintentional poisoning, liver, kidney and lung disease history. 1.5 Diagnostic criteria Diagnostic criteria of multiple organ failure following two or more persons: (1) central nervous system failure, a disturbance of consciousness, coma, convulsions, seizures or brain edema were . (2) heart failure, cardiogenic shock, heart failure, myocardial infarction, arrhythmia, transient cardiac arrest. (3), respiratory failure, severe hypoxemia or in need of artificial mechanical ventilation. (4), liver failure, total bilirubin> 5.134 mmol / L, hypoproteinemia. ALT, AST and LDH more than 2 times more than normal. (5) renal failure, blood urea nitrogen> 10.7 mmol / L or serum creatinine> 177 μmol / L or both urine output <500 ml/24 h. (6), gastrointestinal failure, stress ulcer, vomiting blood or black stools, blood transfusion or acute erosive endoscopic mucosal bleeding, history of peptic ulcer. 1.6 Organ involvement which often involve the brain and respiratory system , were 62 cases (94%), 64 patients (about 97%). Table 1 Incidence of various organs. Table 1 organophosphate poisoning complicated by multiple organ failure rate