急性有机磷中毒者临床结局2年后的随访调查
Two-year follow-up study on clinical outcomes of non-occupational pesticides poisoning
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摘要:目的 探讨急性有机磷农药中毒(AOPP)患者的远期临床结局。方法 对132例口服有机磷中毒者进行急性中毒2年后的随访调查。结果 (1) 12例失访, 其中1例因出现有机磷迟发性神经病(OPIDP)再服有机磷农药自杀死亡, 失访率为9.09%。(2)11例于急性中毒后2~8周出现OPIDP, 仅5例赴医院诊治, 1例于6个月后完全恢复, 其余未经医院治疗亦都有不同程度的好转。中毒后1年内OPIDP发生率为917%, 2年后为6.67%。(3)急性中毒时有38例同时诊断有精神病, 其中枢神经与精神症状的发生率于2年后比较无明显变化。82例非精神病者在急性中毒时出现的中枢神经与精神症状中, 除头痛、头晕等于中毒2年后恢复较好外, 其余如睡眠障碍、记忆障碍、情绪低落和急躁易怒等症状均无明显改变。结论 大多数急性有机磷农药中毒者临床结局较好, 遗留迟发性神经病的后遗症者不足10%, 少数患者可能遗留中枢神经与精神症状。中毒者恢复情况可能与救治情况有关, 急性中毒后症状的恢复情况应引起医患双方的重视。Abstract:Objective To investigate the neurological and psychiatric clinical outcomes of acute organophosphate insecticides(OPs)poisoning.Methods A two-year follow-up study was per for med in 132 O Ps poisoning patients with non-occupational exposure.Results (1) The prevalence of organophosphate induced delayed polyneuropathy(OPIDP)was 9.17%.Most of the OPIDP cases recovered gradually.Five of them were treated in the hospital and only one patient recovered entirely.Another patient ingested insecticides again and died.(2)The psychiatric symptoms of 38 cases who were diagnosed as psychiatric diseases during acute OPs poisoning remained unchanged.Several neurological and psychiatric symptoms in the rest patients were allev iated significantly.However, the frequency of insomnia, amnesia, depression and imitability was still higher than that before acute poisoning.Conclusion The outcomes of most patients of acute OPs poisoning were favor able.9.17% of the patients developed OPIDP.The psy chiatric symptoms remained unchanged in patients complicated with psychiatric disorders.The central nervous system manifestations recovered significantly in the rest of patients except few neurotic symptoms.
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