Lou X H, Zhang B W, Ma X C
Department of Emergency, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2022 Oct 20;40(10):779-782. doi: 10.3760/cma.j.cn121094-20211013-00499.
Thiamethoxam belongs to the second generation of neonicotinoid insecticides, and case of acute poisoning with thiamethoxam had never reported in China. This paper reviewed a case of oral poisoning with thiamethoxam pesticides, the patient suffered vomiting, generalized convulsions, confusion, and decreased oxygen saturation. After treated with gastric lavage, ventilator support, and the use of propofol, midazolam, sodium phenobarbital, and sodium valproate, the convulsions could not be controlled. Untill treated with penehyclidine hydrochloride and hemoperfusion combined with hemofiltration, the patient finally recovered and was discharged from the hospital. We suggest that the main treatments for acute severe thiamethoxam poisoning are decontamination and symptomatic support, pentoxifylline hydrochloride and hemoperfusion combined with hemofiltration may improve the patients' prognosis.
噻虫嗪属于第二代新烟碱类杀虫剂,在中国从未有过噻虫嗪急性中毒的病例报道。本文回顾了1例噻虫嗪农药口服中毒病例,患者出现呕吐、全身抽搐、意识模糊及血氧饱和度下降。在经过洗胃、呼吸机支持以及使用丙泊酚、咪达唑仑、苯巴比妥钠和丙戊酸钠治疗后,抽搐仍无法得到控制。直到使用盐酸戊乙奎醚并进行血液灌流联合血液滤过治疗后,患者最终康复出院。我们认为,急性重度噻虫嗪中毒的主要治疗方法是清除毒物及对症支持治疗,盐酸戊乙奎醚及血液灌流联合血液滤过可能改善患者预后。