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急性有机磷农药中毒(AOIP)抢救成功的关键是对2个死亡高峰期防治措施是否得力,基层医务人员已普遍掌握了抢救AOIP首要措施是使用阿托品,它能尽快解除由乙酰胆碱积聚对重要脏器血管痉挛,改善微循环,使第一个死亡高峰期(服毒24小时内)明显下降;第二个死亡高峰期(服毒2～7天)死亡率仍在上升,死因主要为反跳;如何防治反跳,提高抢救成功率,改善预后,根据本人粗浅体会并结合文献作一简述。 1.彻底清除毒物 (1)常规洗胃:口眼AOIP病人入院后不论服毒时间长短,病情轻重立即用凉水洗胃,因凉水洗胃可促进胃粘膜血管收缩,减少毒物吸收。 (2)切断中毒途径:脱去带有农药的衣物,用凉水擦洗沾有农药的皮肤。减少皮肤粘膜农药吸收。
Acute organophosphorus pesticide poisoning (AOIP) the key to the success of the rescue is the prevention and treatment of 2 peak death rate is effective, grassroots medical staff have generally mastered the first measure to rescue AOIP is the use of atropine, which can lift the accumulation of acetylcholine as soon as possible on the vital organs Vasospasm, improve microcirculation, the first peak of death (poisoning within 24 hours) decreased significantly; the second death peak (2 to 7 days poisoning) mortality is still rising, the main cause of death is rebound; how to prevent Rebound, improve the success rate of rescue, improve prognosis, based on my superficial experience combined with a brief description of the literature. 1. Complete removal of poisons (1) conventional gastric lavage: Oral AOIP patients admitted to hospital regardless of the length of time, the severity of immediate gastric lavage with cold water, cold water gastric lavage can promote gastric mucosal vasoconstriction, reduce the absorption of poisons. (2) cut off the poisoning path: take off clothing with pesticides, scrub the skin with pesticides in cold water. Reduce skin mucosal pesticide absorption.