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中间肌无力综合征是有机磷急性中毒最严重的并发症,病死率高,目前尚无有效的治疗对策。现将诊治的2例(包括会诊所见1例)结合文献报告如下。例1:男性,44岁。因自服“多灭光”有机磷混合剂50ml及白酒,约半小时后被发现跌倒以及鼻腔出血,急诊入院。查体:神志不清,体温 T39℃,P100次/min,R18次/min,BP105/70mmHg,瞳孔 2mm,双侧等圆等大,光反应迟钝。急插胃管洗胃,应用解磷定、阿托品等治疗;并于1小时内达到阿托品化。心电图示窦性心动过速,T波变化,血清胆碱酯酶(ChE)0u,电解质正常,总胆红素34.9μmol/L,直接胆红素13.μmol/L,谷丙转氨酶(AST)84u/L,谷草转氨酶(ALT)62u/L,磷酸肌酸激酶(CK)448u/L,乳酸脱氢酶(LDH)320u/L。
Median muscle weakness syndrome is the most serious complication of acute organophosphate poisoning, high mortality, there is no effective treatment. Now the diagnosis and treatment of 2 cases (including clinics see 1 case) combined with the literature report is as follows. Example 1: Male, 44 years old. Due to self-serving “more light” 50ml of organic phosphorus mixture and white wine, about half an hour later was found to fall and nasal bleeding, emergency admission. Physical examination: unconsciousness, body temperature T39 ℃, P100 times / min, R18 times / min, BP105 / 70mmHg, pupil 2mm, bilateral equal circle, light reaction slow. Gastric anastomosis gastric lavage, the application of phosphate solution, atropine treatment; and within 1 hour to achieve atropine. ECG showed sinus tachycardia, T wave changes, serum cholinesterase (ChE) 0u, electrolyte normal, total bilirubin 34.9μmol / L, direct bilirubin 13.μmol / L, alanine aminotransferase (AST) 84u / L, aspartate aminotransferase (ALT) 62u / L, creatine kinase CK 448u / L and lactate dehydrogenase 320u / L.