小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 分泌物增加
- 肌束震颤
- 针尖样瞳孔
- 独特的气味
- 胸部湿罗音和干罗音
- 半清醒/昏迷
其他诊断因素
- 视觉障碍
- 呕吐
- 流感样症状
- 大小便失禁
- 近端肌肉无力
- 深腱反射异常
- 心率异常
- 血压异常
- 呼吸减弱
- 体温过低
- 惊厥
- 迟发性中枢神经系统和外周（主要是运动神经）神经病
危险因素
- 农药可得性
- 有自伤史或最近出现人际冲突
- 精神疾病
- 酒精或药物滥用
诊断性检查
首要检查
- 阿托品治疗试验
- 血浆胆碱酯酶
- 红细胞胆碱酯酶
需考虑的检查
- 胸部 X 线检查
- 心电图 (ECG)
- 血气
治疗流程
疑似中毒
职业或意外中毒
故意摄入或采用神经毒剂的恐怖袭击/战争
中间综合征
有机磷诱发的迟发性神经病变
撰稿人
作者
Nicholas Buckley, MD, FRACP
Professor of Clinical Pharmacology
Pharmacology Department
Sydney Medical School
University of Sydney
Sydney
New South Wales
Australia
利益声明
NB is an author of a number of references cited in this topic.
同行评议者
Steven B. Bird, MD, FACEP
Assistant Professor of Emergency Medicine
Division of Medical Toxicology
University of Massachusetts Medical School
North Worcester
MA
利益声明
SBB declares that he has no competing interests.
Cynthia K. Aaron, MD, FACMT, FACEP
Program Director
Medical Toxicology
Regional Poison Center
Children's Hospital of Michigan
Detroit
MI
利益声明
CKA holds stock in Merck Pharmaceuticals and is a paid consultant for ToxEd. She was briefly a paid consultant for Lexi-Comp.
Kent R. Olson, MD
Professor Medical Director
San Francisco Division
California Poison Control System
San Francisco
CA
利益声明
KRO declares that he has no competing interests.
Ruben Thanacoody, MD, FRCP(Edin)
Consultant Physician and Clinical Toxicologist
National Poisons Information Service (Newcastle)
Newcastle-upon-Tyne
UK
利益声明
RT declares that he has no competing interests.
鉴别诊断
- 氨基甲酸酯中毒
- 氯代苯氧型除草剂中毒
- 阿片类药物过量
更多 鉴别诊断指南
- 管理急性有机磷农药中毒
- 急性杀虫剂中毒的临床处理：预防自杀行为
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