Levy-Khademi Floris, Tenenbaum Ariel N, Wexler Isaiah D, Amitai Yona
Department of Pediatrics, Hadassah-Mount Scopus, Hadassah University Hospital, Jerusalem, Israel.
Pediatr Emerg Care. 2007 Oct;23(10):716-8. doi: 10.1097/PEC.0b013e318155ae0e.
To describe the demographic characteristics, clinical course, and outcome of children with acute organophosphate (OP) poisoning admitted to a regional medical center.
The clinical charts of all children admitted to the pediatric wards in Hadassah University Hospital with a diagnosis of acute OP intoxication were reviewed.
During the study period (1989-2003), 31 children, mean age 5.6 +/- 3.9 years, presented with manifestations of acute OP poisoning. In 71% of the patients, it was possible to identify the toxin, most commonly parathion and diazinone. The most common route of exposure was ingestion of agricultural products treated with OPs (71%). The major clinical manifestation was neurological, with most of the patients presenting with coma and/or seizures (71%). The classic muscarinic and nicotinic signs of intoxication including increased secretions, bradycardia, fasciculations, and miosis were less common in our patient population. Treatment included decontamination, administration of antidote, and supportive care. Most patients responded well to treatment, but 2 patients (6.4%) died.
The manifestations of OP poisoning in children are different from those of adults. Pediatricians should be aware of these differences because in some cases, a history of OP exposure is not obtained.
描述入住某地区医疗中心的急性有机磷（OP）中毒儿童的人口统计学特征、临床病程及转归。
回顾了哈达萨大学医院儿科病房收治的所有诊断为急性OP中毒儿童的临床病历。
在研究期间（1989 - 2003年），31名儿童（平均年龄5.6±3.9岁）出现急性OP中毒表现。71%的患者能够明确毒素，最常见的是对硫磷和二嗪农。最常见的接触途径是摄入用OP处理过的农产品（71%）。主要临床表现为神经系统症状，大多数患者出现昏迷和/或惊厥（71%）。中毒的典型毒蕈碱样和烟碱样体征，包括分泌物增多、心动过缓、肌束震颤和瞳孔缩小，在我们的患者群体中较少见。治疗包括去污、给予解毒剂和支持治疗。大多数患者对治疗反应良好，但2例患者（6.4%）死亡。
儿童OP中毒的表现与成人不同。儿科医生应了解这些差异，因为在某些情况下，无法获取OP接触史。
