About32casesoforganophosphatepoisoningfirstaidexperiencecombinedarrhythmia-毕业论文翻译

1、About 32 cases of orga nophosphatepois oning first aid experie nee comb inedarrhythmiaAbstract Objective To in vestigate the acute orga nophosphatepois oningcomplicated arrhythmiaemerge ncy experie nee. Methods Retrospective an alysis of 32 cases of acute orga nophosphorus pesticide pois oning compl

2、icated arrhythmias in patie ntswith emerge ncyclinical data of 32 patients after treatment, 29 patients were discharged without sig nifica nt sequelae 3 cases died, the success rate was 90.6%.Con clusi onpois oningcomplicated arrhythmiaemerge ncysymptomatictreatme nt should be rapid, with early appl

3、icati onofmyocardial protecti on drugs and an ti-arrhythmic drugs to preve nt the late complicatio ns of the heart, to improve the healing of organophosphoruspesticidepoisoninghavesig nifica nt value.Keywordspois oningemerge ncyarrhythmiaAcute orga nophosphatepois oning(AOPP) is a com mondisease of

4、acute pois oning 1. Severe orga nophosphorusiipois oning can cause arrhythmia caused by multiple orga n dysfu ncti onsyn drome(MODS), multiple cen tral n ervoussystem, respiratory system, circulatory system, digestive system and other organ failure. Positive, correct, and reas on able treatme nt is

5、key to successful treatme nt, now our departme nt in February 2008 to September 2010 were treated for acute orga nophosphate pesticide pois oning in 32 patie nts with arrhythmiascomb inedfirst-aidexperie nee are summarized below.1 Materials and Methods1.1 Generalinformation on 32 cases of acute orga

6、nophosphorus pesticide pois oningcomplicated arrhythmiapatie nts,12males and 20 females, aged 20-68 years (mea n 34.5 + -1.5 years). Poisoningways: orally in 28 cases of pesticidepoisoning, skin 4 cases of pesticide poisoning, from pois oning to treatme nt time of 30 minu tes -3 hours. the amountof

7、medicationranging from 20ml-200ml. basedon cli nical mani festati ons and serum choli nesterase activityin sub-light,moderate and severe3: mildpoisoning 17 cases, moderate poisoning, 10 cases of severe pois oning in 5 cases.1.2 Rescue methods 1.2.1 The complete removal of toxic Leave the skin as soo

8、n as possible pois oning by orga nic phosphorus pesticide-c on tam in ated environment,the replacementby organicphosphoruspesticides contaminatedclothing, wash thoroughly withwatercon tam in atedby pesticides,sk in,hair Oralpois oning patie nts, as long as con diti ons permit should be timely and th

9、orough gastric lavage using warm water , close observation of patients duringthe gastric lavagecha nges in vital sig ns, pay atte nti on to the occurre nee of complicationsin order to avoid delay in treatment.retai nedafterwash ingthe stomach, 2-4 hours ofintermittentwash, the emergencytreatmentof a

10、cuteorga nophosphatepois oning,atrop ine use a lot ofstomach motility decreased or disappeared, the expa nsion of the in test ine,in testi nalgas producti onglycolysis, thepressure in creased, has en tered the in testi nal reflux in to the stomach of orga nic phosphorus, so we have improvedthe gastr

11、iclavagemethod,thepatie ntcompletelyretai nedaftergastriclavagetube,con ti nu ousdrain agegastricjuice,andhas asmallamountof liquidgastric lavage(500-1000ml / seco nd), 2-3 days after thefluid drain age tuberemoved whe nno pesticide taste byrepeated gastric lavage, then reduce the poisoning,topreven

12、t the rebound,and from to the decompressioneffect.1.2.2 the applicationof anti-arrhythmiadrugsAtropi ne is a commo nly usedan ti-arrhythmia drugs, theuse of prin ciples early eno ugh, fast delivery. s First dosage of atropine: mild poisoning1-3mg, moderatepois oning4-10mg, severe pois oning,10-20mg

13、Ge neralpoisoning through skin absorption,with the lower limit,absorpti on by the digestive tractwith the upper limit ofpois oning.To the patient without causing rapid atropine pois oning atrop ine prin ciple of atrop ine after the patie nts, depe ndingon the disease to reducethe dosage ofatrop ine,

14、atrop ine mai ntai nedaround48h, and the nsmaller doses to mai ntain, at least maintain 1-2 days later to 0.6mg bid or qid, until the patientwhole bloodcholinesterase stable at 60% or symptoms disappearedcompletely.While additi onal capacity, based on the useof the diuretic furosemide plug microph o

15、ne,prompti ngpois on excluded atte ntio n to electrolyte cha nges. 1.2.3 symptomatic and supportivetreatme ntMai ntai n respiratory fun cti on, to keep the airway ope n, if n ecessary, artificial respiratio n, correct acid-base bala nee and electrolyte disorders,preve nti onof stress ulcer,gastroint

16、estinalbleeding,cerebral edema, while part ofthe pois oning, there are some psychological problems of patie nts, so therapy particularly importa nt should be the patient s ideological work to do to active treatment, which can be successful rescue is very importa nt.2 Results 32 patients after treatm

17、ent,29patie ntswere discharged withoutsig ni fica ntcomplications. 3 cases of oral volume of highly toxic organophosphate pesticidepoisoningand died a longtime, the success rate of 90.6%, le ngth of stay 3-25 days, average len gth of stay 13.5 days.3 Discussi onChina is an agriculturalproduc ingcoun

18、 try, acuteorga nophosphoruspesticidepois oning is acom moncause of pois oning.Orga nophosphorus pesticide pois oning pois oning mainly on the inhibitionof acetylcholinesterase,causing centralexcessive accumulati on of en doge nousacetylcholi ne,exciteme nt and N M receptor receptors, choli nergic n

19、 erve impulses continu e, result ing in failure after the first series of excited alkali-like poisonous weeds,nicotinicandcen tral n ervous system symptoms of pois oning, caused by abno rmalheart rhythms, brain dysf un cti on,respiratoryfailure and other pathophysiological states, and in creased in

20、teracti on with each other, and high mortality.Patie ntswith complete removal of orga nicphosphorus pesticidepoisonis one of the keys tosuccessfultreatme nt,first time, the sooner the bettergastric lavage, oral pois oning, gastric lavage with in30minu tes of the best, but the pois on in criticallyil

21、lcomatose patie nts eve n after more tha n 24 hours should gastric lavage 2 For those with mild pois oning can be a clear method of oral gastric lavage to in duce vomiti ng, i n severe pois oning suitable in tubati on gastric lavage.Firstcame to treatment because the patient, the doctor maynot be cl

22、ear what kind of pesticidepoisoning,so wealways use warm water fed in an ti-arrhythmia, you should immediately beg in to use atrop ine,such as clea ning thestomach must not start un til after the use of in hibiti on of acetylcholi nesteraseorga nophosphatemore last ing, theeffects of in trave nousat

23、rop ine to beg in in 1-4 minu tes,eightminu tes andreachedthe peakin the fast metabolism; patie nts with orga nophosphate pois oning in vivo accumulation of a large number of acetylcholine, atropine s NPC tolerated dose than normal, so the applicati on of atrop ine should be early eno ugh and repeated to maintain, early eno ugh, fast atrop ine can beeffectiveaga instrespiratory cen ter depressi on,bron chospasm,excessive respiratory secreti ons andcirculatory failure in this group showed that, after the rescue, the 29 cases were discharged withoutsignificantcompl