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患者男,27岁,因口服剧毒有机磷农药对硫磷(1605)约400ml后2小时入院,查体:浅昏迷口吐白沫,大汗淋漓,双侧瞳孔针尖大小,双肺满布湿罗音,心率62次/分,心音低弱,面部及四肢肌束颤动。入院后急给予插管洗胃,洗出大量乳白色蒜臭样液体,至洗胃液清晰无味,共用洗胃液20000ml,后胃管注入20％甘露醇导泻。同时迅速建立静脉通路,静注阿托品、解磷啶至入院2小时阿托品用至110mg时,达阿托品化,神志清醒,阿托品间断静注维持阿托品化。查胆碱酯酶活力为0单位,考虑患者口服量大,入院时间长,遂给予换血疗法。于入院后第4小时即给予放血500ml,输新鲜血
Male, 27 years old, due to oral toxicity of organophosphorus pesticide parathion (1605) about 400ml after 2 hours admission, physical examination: shallow stupor spit foam, sweating, bilateral pupil needle size, lung covered with cloth Wet rales, heart rate 62 beats / min, low heart sounds, facial and limb muscle bundle fibrillation. Immediately after admission to give intubation gastric lavage, wash out a large number of white garlic odor-like liquid, clear and odorless gastric lavage fluid, common gastric lavage 20000ml, gastric tube into 20% mannitol catharsis. At the same time the rapid establishment of intravenous access, intravenous atropine, phosphinodilation to hospital 2 hours atropine to 110mg, daatolization, conscious, atropine intermittent intravenous maintenance of atropine. Check cholinesterase activity of 0 units, taking into account the patient oral dose, admission for a long time, then give the exchange of blood therapy. In the first 4 hours after admission give blood 500ml, lose new blood