Rolfsjord L B, Fjaerli H O, Meidel N, Stromme J H, Kowalczyk M, Jacobsen D
Department of Pediatrics, Hedmark Central Hospital, Elverum, Norway.
Vet Hum Toxicol. 1998 Aug;40(4):222-4.
A previously healthy 2-y-old boy was admitted to the hospital 30 min after the ingestion of 10 ml of demeton-S-methyl (META-SYSTOX). Treatment consisted of gastric decontamination, atropine, reactivator (obidoxime) and supportive therapy. Atropine was given to control the muscarinic features. Assisted ventilation was required for 6 h; however, this treatment was able to be discontinued following the second injection of obidoxime 11.5 h after the ingestion. Excess salivation and slight bradycardia were easily controlled with small doses of atropine for 5 d following admission to Ullevaal Hospital. Further course was uneventful, and the patient was discharged on the 8th d without any sequelae. Plasma cholinesterase levels were initially low (<400 U/l), but returned to reference values upon discharge. In this case, adequate supportive therapy and the rapid administration of both atropine and obidoxime were clearly associated with a favorable outcomes
一名既往健康的2岁男孩在误服10毫升甲基内吸磷（甲基1605）30分钟后被送入医院。治疗包括洗胃、使用阿托品、复活剂（双复磷）及支持治疗。给予阿托品以控制毒蕈碱样症状。需要辅助通气6小时；然而，在误服11.5小时后第二次注射双复磷后，该治疗得以停止。入院后在Ullevaal医院，小剂量阿托品轻松控制了过量流涎和轻度心动过缓达5天。后续病程平稳，患者于第8天出院，无任何后遗症。血浆胆碱酯酶水平最初较低（<400 U/l），但出院时恢复至参考值。在该病例中，充分的支持治疗以及阿托品和双复磷的快速使用显然与良好预后相关。
