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小儿有机磷中毒病史往往不明确,症状体征不典型,容易误诊误治。笔者自1988年8月——1998年10月共收治小儿有机磷中毒17例,疗效满意,报道如下。1 临床资料1.1 一般资料 本组17例,男9例,女8例。年龄最小8个月～14岁。其中皮肤粘膜吸收中毒9例,误服中毒8例。1.2 症状体征 憋气7例,口吐白沫7例,大汗5例,哭闹不安3例,呕吐9例,瞳孔缩小10例,昏迷2例,心率慢6例,双肺细罗音5例。1.3 治疗及转归 属口服者立即给予清水彻底洗胃,并经胃管给予不等量导泻剂。属皮肤吸收者彻底清洗皮肤,更换衣物,然后按中毒程度应用阿托品及胆碱酯酶复活剂,达到阿托品化后逐渐减量,直至症状体征消失。同时对症处理;缺氧者吸氧,抽搐者镇静。结果治愈16例,死亡1例。2 讨论
The history of pediatric organophosphate poisoning is often not clear, the symptoms and signs are not typical, easy misdiagnosis and mistreatment. The author from August 1988 - October 1998 were treated children with organophosphate poisoning in 17 cases, with satisfactory results, the report is as follows. 1 Clinical data 1.1 General Information The group of 17 cases, 9 males and 8 females. The youngest 8 months to 14 years old. Nine cases of skin mucosal absorption poisoning, poisoning poisoning in 8 cases. 1.2 symptoms and signs suffocation 7 cases, 7 cases of foaming at the mouth, sweating in 5 cases, 3 cases of crying unease, vomiting in 9 cases, pupil shrinkage in 10 cases, coma in 2 cases, slow heart rate in 6 cases, lungs sore in 5 cases . 1.3 treatment and return to an oral person immediately give clear water thoroughly gastric lavage, and given by the gastric tube ranging from laxatives. Is a skin absorbers thoroughly clean the skin, changing clothes, and then use atropine and cholinesterase resuscitator by poisoning, to achieve tapering after atropine, until the symptoms and signs disappear. At the same time symptomatic treatment; hypoxia oxygen, convulsions were sedated. Results of 16 cases were cured, 1 died. 2 discussions