Bardin P G, van Eeden S F, Moolman J A, Foden A P, Joubert J R
Department of Internal Medicine, University of Stellenbosch, Tygerberg Hospital, Cape Town, South Africa.
Arch Intern Med. 1994 Jul 11;154(13):1433-41.
Organophosphate insecticides may cause serious poisoning either accidentally or by deliberate ingestion. Toxic symptoms are produced by acetylcholine accumulation at cholinergic receptors. Diagnosis is based on history of exposure or ingestion, symptoms and signs of cholinergic overactivity and a decrease in serum pseudocholinesterase levels. Following diagnosis, grading of disease severity may identify patients with serious poisoning who should receive treatment in intensive care using adequate doses of anticholinergic drugs. Complications, particularly ventricular arrhythmias, central nervous system depression or seizures, and respiratory failure, should be anticipated and treated. Relapse may occur after seemingly successful treatment. Public education with regard to symptoms of toxicity must be encouraged, and physicians must provide skilled treatment for a potentially lethal condition.
有机磷杀虫剂可能因意外或故意摄入而导致严重中毒。毒性症状是由乙酰胆碱在胆碱能受体处蓄积产生的。诊断基于接触或摄入史、胆碱能活动亢进的症状和体征以及血清假性胆碱酯酶水平降低。诊断后，疾病严重程度分级可识别出应在重症监护室使用足量抗胆碱能药物进行治疗的严重中毒患者。应预期并治疗并发症，尤其是室性心律失常、中枢神经系统抑制或惊厥以及呼吸衰竭。看似成功的治疗后可能会复发。必须鼓励开展关于毒性症状的公众教育，医生必须为这种潜在致命状况提供专业治疗。
