Munda Punam K, Bodra Diljeet, Singh Parul, Agarwal Krati
Department of Medicine, RIMS, Ranchi, Jharkhand, India.
Department of Nephrology, Father Muller Medical College, Mangalore, Karnataka, India.
J Family Med Prim Care. 2025 Mar;14(3):921-927. doi: 10.4103/jfmpc.jfmpc_1285_24. Epub 2025 Mar 25.
Organophosphorus insecticides, widely used worldwide, are a significant public health risk in developing countries, causing 3 million poisonings and 300,000 deaths annually. Despite a 20% fatality rate in Asia, improved care is reducing mortality. Improper storage and accessibility contribute to frequent suicides, especially among lower socio-economic groups. Cardiac complications, often fatal, are preventable with early treatment. This study examines 60 acute poisoning cases at RIMS, Ranchi, highlighting the need for improved management.
This prospective clinical study, conducted from May 2018 to November 2019, involved 60 patients with acute organophosphorus poisoning admitted within 24 hours of ingestion. Comprehensive management included gastric lavage, activated charcoal, antidotes (atropine and pralidoxime), and supportive measures. Clinical and biochemical assessments, including echocardiography, monitored patient progress and treatment outcomes.
In a study of 60 acute organophosphorus poisoning cases, common early symptoms included lacrimation, salivation, blurring vision, nausea, and vomiting. Pupil constriction was an early sign. Bradycardia occurred in 46.67% of patients. Despite intensive care, 6.67% succumbed, with causes including ventricular fibrillation, aspiration pneumonia, and non-cardiogenic pulmonary edema.
Future studies should address the infrastructural gaps of this study, as acute organophosphate poisoning constitutes over 75% of hospital poisoning cases. Early recognition and prompt treatment of cardiac complications can prevent fatalities, highlighting the need for improved management protocols and healthcare infrastructure.
有机磷杀虫剂在全球广泛使用,在发展中国家是重大的公共卫生风险,每年导致300万例中毒和30万人死亡。尽管在亚洲病死率为20%,但改善护理正在降低死亡率。储存不当和易获取性导致自杀频发,尤其是在社会经济地位较低的群体中。心脏并发症往往致命,但早期治疗可预防。本研究调查了兰契市 Rajendra 医学科学研究所(RIMS)的60例急性中毒病例,强调了改善管理的必要性。
这项前瞻性临床研究于2018年5月至2019年11月进行,纳入了60例在摄入后24小时内入院的急性有机磷中毒患者。综合管理包括洗胃、活性炭、解毒剂(阿托品和氯解磷定)以及支持措施。临床和生化评估,包括超声心动图,监测患者的病情进展和治疗结果。
在对60例急性有机磷中毒病例的研究中,常见的早期症状包括流泪、流涎、视力模糊、恶心和呕吐。瞳孔缩小是早期体征。46.67%的患者出现心动过缓。尽管进行了重症监护,仍有6.67%的患者死亡,死因包括心室颤动、吸入性肺炎和非心源性肺水肿。
由于急性有机磷中毒占医院中毒病例的75%以上,未来的研究应解决本研究中的基础设施差距问题。早期识别和及时治疗心脏并发症可预防死亡,这突出了改进管理方案和医疗基础设施的必要性。