LEACH P H
Calif Med. 1953 Jun;78(6):491-5.
Inhalation, skin absorption or ingestion of insecticides containing organic phosphorus may result in abrupt onset of serious illness several hours following exposure. Because of the acute onset, often at night, the patients usually are observed by the first available physician rather than by an industrial physician. Prompt recognition and adequate treatment are essential to prevent death. The organic phosphorus radical has the specific effect of inactivating cholinesterase in the body. When cholinesterase is reduced below a critical level continuous stimulation of the entire parasympathetic nervous system results. The major symptoms are diarrhea, vomiting, pulmonary edema, respiratory difficulty and tonic convulsions. Myosis is frequently present and when found is almost pathognomonic, especially if associated with other symptoms. Treatment consists essentially of heroic doses of atropine or a similar parasympathetic inhibitor, plus supportive therapy. Patients who do not die recover rapidly and completely, but they should not risk re-exposure until cholinesterase activity in the blood reaches a static level which may take as long as ten weeks.
吸入、皮肤吸收或摄入含有有机磷的杀虫剂可能会在接触数小时后突然引发严重疾病。由于发病急促，且通常在夜间，患者通常由最先接诊的医生诊治，而非职业医生。迅速识别并进行充分治疗对于预防死亡至关重要。有机磷基团具有使体内胆碱酯酶失活的特殊作用。当胆碱酯酶降至临界水平以下时，会导致整个副交感神经系统持续受到刺激。主要症状包括腹泻、呕吐、肺水肿、呼吸困难和强直性惊厥。瞳孔缩小常常出现，一旦发现几乎具有诊断意义，尤其是与其他症状同时出现时。治疗主要包括大剂量使用阿托品或类似的副交感神经抑制剂，以及支持性治疗。未死亡的患者恢复迅速且完全，但在血液中胆碱酯酶活性达到稳定水平之前，不应再次接触，这可能需要长达十周的时间。
