Risk Factors Analysis Of Acuet Severe Orgnaophorphous Pesticide Poisoning

Objective Acute Organophosphorus pesticide poisoning (AOPP) is a common pesticide poisoning, usually respiratory failure is the leading cause of death in patients. In recent years, the understanding of the pathological mechanisms of organophosphate poisoning deepening, improved treatment modalities. Ventilator use, simple respiratory failure due to reduction in the event of death in patients with the causes and circumstances of death in patients with the corresponding changes also occurred, collected some severe organophosphate poisoning patients medical records related analysis, sum up experience and lessons learned to explore a more reasonable and effective acute organophosphorus poisoning treatment programs to provide new ideas and methods for the clinical treatment.Methods From February2000to February2010my hospital for treatment of severe acute organophosphate poisoning patients clinical data, selected candidates within24hours of hospital treatment in patients with acute severe poisoning and assault the amount of pralidoxime chloride therapy(the amount of the first day is about10g, used in conjunction with the following methods:pralidoxime chloride1g intramuscularly,1hour, connected to three times, once every two hours later, connected to three times, and then after every4hours until the time24hours,24hours, every4to6hours1,2or3days, this one course, and later as the disease.) as a basis for treatment. Prevention of complications related to protection of organ function, anti-infective, correcting water, electrolyte and acid-base balance and nutrition support therapy. Such as respiratory failure, open airway in a timely manner, to keep the airway open, ventilator-assisted breathing. Taking poison a large amount of poisoning early timely given blood perfusion, acceleration gets rid of toxicokinetics. Eliminated in accordance with the standards set, the result is not clear a patient.10years, a total of242oral poisoning patients, which meet the conditions of the deaths of25cases the survival cases to217cases. OUTCOME MEASURES:taking poison dose poisoning species, initial cholinesterase activity, breathing, heartbeat pause, biochemical indicators. According to the prognosis, is divided into the group of death and survival group, clinical manifestations, took poison dose of poison types, complications, and biochemical indicators of different groups of patients taking poison dose, species, initial cholinesterase activity, heart rate, apnea, poisoning24hours visceral function alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, cardiac enzymes creatine kinase isoenzyme, lactate dehydrogenase, record the cause of death in patients classified summary. Application of statistical software for data analysis, comparing the average age of death between the group and cure patients taking poison amount is taking poison to gastrolavage time, the average difference of cholinesterase water, death group in a variety of complications (such as the liver injury, myocardial injury, upper gastrointestinal bleeding, acute pancreatitis and multiple organ failure), the incidence rate higher than that of the control group, and the difference was statistically significant. Measurement data using t test, count data were compared with the x2test.Results:A total of242cases of AOPP patients,25patients died (10.3%).25deaths in patients with both acute severe organophosphorus pesticide poisoning,9males and15females, all patients underwent mechanical ventilation, all patients had a lung infection,6patients after cardiopulmonary resuscitation, complications liver injury, myocardial injury, upper gastrointestinal bleeding, acute pancreatitis and multiple organ failure in the main.Conclusion:the leading cause of death in patients with respiratory and circulatory failure, and then this merger on the basis of multiple organ failure, in addition, the death of patients with low cholinesterase levels compared with the survival group toxicant concentration in the blood, oldertaking poison a large amount of myocardial damage, liver dysfunction, organ damage, took poison to gastric lavage longer the main factors increase the risk of death in patients with death.