Yélamos F, Díez F, Martín C, Blanco J L, García M J, Lardelli A, Peña J F
Servicio de Medicina Interna, Hospital de Torrecárdenas, Almería, Granada.
Med Clin (Barc). 1992 May 9;98(18):681-4.
The aim of the present study was to analyze the epidemiological and clinical characteristics of poisoning by organophosphorus insecticides in the province of Almería.
One hundred eighty-seven patients diagnosed with organophosphorus insecticide poisoning were included from 1981-1986. In all the cases a previously established clinic and therapeutic protocol was applied.
Eighty-six percent of the patients were males with a mean age of 31 years. The poisoning was accidental in 62% of the cases and attempted suicide in 38%. The via of absorption was cutaneous-respiratory in 57% and digestive in 43% of the patients. All the patients presented florid initial cholinergic symptomatology. The presence of bronchorrhea, tremor-fasciculations, respiratory depression and diminution in the level of conscience was associated with severe intoxication. The quantification of acetylcolinesterase was useful as a diagnostic parameter. Global mortality was 4%. Ten percent of the patients developed delayed signs of neurotoxicity.
The high hospital demand for poisoning by organophosphorus insecticide is of note. Hospital mortality is low. The severity of intoxication is related with attempts of autolysis, digestive absorption, appearance of respiratory manifestations and of the central nervous system and the development of complications.
本研究旨在分析阿尔梅里亚省有机磷杀虫剂中毒的流行病学和临床特征。
纳入了1981年至1986年期间诊断为有机磷杀虫剂中毒的187例患者。所有病例均采用先前制定的临床和治疗方案。
86%的患者为男性，平均年龄31岁。62%的病例中毒为意外，38%为自杀未遂。57%的患者吸收途径为皮肤-呼吸道，43%为消化道。所有患者均出现明显的初始胆碱能症状。出现支气管分泌过多、震颤-肌束震颤、呼吸抑制和意识水平下降与严重中毒有关。乙酰胆碱酯酶定量作为诊断参数很有用。总体死亡率为4%。10%的患者出现迟发性神经毒性体征。
值得注意的是，医院对有机磷杀虫剂中毒的需求很高。医院死亡率较低。中毒的严重程度与自溶企图、消化道吸收、呼吸表现和中枢神经系统的出现以及并发症的发生有关。
