非硝硫磷急性中毒静脉滴注脂乳治疗

P. Marinov, Dobri Ivanov, S. Zlateva, S. Dimitrova, G. Kehayova, M. Radeva, S. Stoeva
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摘要

有机磷农药急性中毒因其常见、严重、致死率高,一直是临床毒理学研究的难点。大多数OPs是亲脂性的。近年来,静脉注射脂质乳(ILE)已成功用于治疗急性嗜脂性外源药物中毒。本文报告一例64岁男性口服氟硝硫磷50ml后住院的临床病例。他曾因呼吸急促和意识低下住院,格拉斯哥昏迷量表(GCS)为8。标准化的这种类型的中毒治疗是开始。第3小时开始用20%脂质内酯治疗,注射剂量为1.5 ml/kg,然后以0.25 ml/kg/min的速率输注,总剂量为1000 ml。第16小时意识恢复至GCS-15。在严重的FTO中毒中,ILE可作为控制心脏毒性和神经毒性作用的附加方法。
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Intravenous lipid emulsion infusion in acute intoxication with fenitrothion
Acute intoxications with organophosphorus pesticides (OPs) are a challenge for the clinical toxicology, because they are common, severe and with high lethality. Most OPs are lipophilic. In recent years, intravenous lipid emulsion (ILE) has been successfully used to treat acute poisoning with lipophilic xenobiotics. A clinical case of a 64-year-old male hospitalized after oral intake of 50 ml of fenitrothion is reported. He had been hospitalized with tachypnea and depressed consciousness – 8 by Glasgow coma scale (GCS). Standardized for this type of intoxication treatment was initiated. On the 3rd hour treatment with Intralipid 20% was started, with a bolus dose of 1.5 ml/kg followed by infusion at a rate of 0.25 ml/kg/min to a total dose of 1000 ml. At the 16th hour consciousness was restored to GCS-15. In severe FTO intoxications ILE can be used as an additional method of controlling cardiotoxic and neurotoxic effects.
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