nlwxpearo
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 Posted: Sun 12:53, 20 Mar 2011 Post subject: Acute clinical analysis of 361 cases of poisoning |
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Acute clinical analysis of 361 cases of poisoning chlordimeform
Methylene blue treatment of 195 patients, according to 1 ~ 2mg/kg body weight,[link widoczny dla zalogowanych], if necessary, 2 - 4 hours repeated application of half dose, until the cyanosis disappeared. In addition to the treatment of patients with severe, the discretion of Health tangled with anti-glucocorticoid and prevention of gastrointestinal bleeding; coma with cerebral edema in patients with 20% mannitol and promoting brain cell metabolism drugs; myocardial damage in patients given GIK magnesium and cytochrome C ; hemorrhagic cystitis in patients with 5% per day 200 ~ 300ml intravenous sodium bicarbonate to alkaline urine, and applying hemostatic sensitivity,[link widoczny dla zalogowanych], vitamin K3 and other hemostatic agent case; blood pressure decreased by application of vasopressors; gastrointestinal bleeding given the appropriate treatment; respiratory and circulatory failure were applied respiratory stimulants and vasoactive drugs. The group was treated with endotracheal intubation l6 artificial oxygen ventilation balloon compression. 21 cases of high frequency jet ventilator oxygen nasal catheter. Results of the comprehensive rescue, in addition to 5 patients discharged in critical condition, 3 large amount of poison to the hospital later died, 353 patients were cured and discharged, with the anti-2 weeks without sequelae. Discussion is a highly effective broad-spectrum chlordimeform ... agricultural pesticides and organic nitrogen acaricidal drugs. Widely used in domestic farm rice stem borer and cotton bollworm control. Pesticide poisoning caused mainly by inadequate protection, absorption through the skin and respiratory tract. 361 cases in this group were 25% chlordimeform oral liquid. Chlordimeform rapidly absorbed by the digestive tract and completely metabolized in the body break down 【2J soon. Metabolites of 4 A toluidine chloride. Most chlordimeform and metabolites excreted by the kidneys, with a small amount of feces, milk discharge,[link widoczny dla zalogowanych], easily biodegradable, fast excretion, no significant accumulation in tissues. Chlordimeform 4 metabolites in the body of a toluidine chloride 3 with a similar anesthetic effects of lidocaine, in the anesthetized brain tissue could also inhibit the heart, causing methemoglobinemia. Decreased red blood cell oxygen carrying capacity. As Chlordimeform urinary tract and its metabolites excreted by, it can cause hemorrhagic cystitis. Symptoms appear sooner or later and extent, depending on the amount of poison. The main symptoms of the nervous system, urinary system symptoms, and severe cyanosis poisoning can occur. And even respiratory failure. Early detection and thorough treatment of gastric lavage is the key to chlordimeform poisoning. As Chlordimeform more stable in the acidic environment ..., and in weak acid and weak base solutions fast hydrolysis. Gastric lavage is available when 2% sodium bicarbonate solution. The group of 82 patients with gross hematuria, urine has red blood cells,[link widoczny dla zalogowanych], white blood cells were 210 cases, were poisoned after 6 hours, after alkalization of urine to relieve the symptoms disappear after a small dose of methylene blue (1-2mglg) 2 to 4 per day second, suitable for moderate to severe cyanotic patients. The excessive doses of methylene blue, but to make hemoglobin ferrous iron into ferric iron to form methemoglobin L4J, increased cyanosis, or appear to the side effects of methylene blue. 5 patients in this group of patients with moderate poisoning each methylene blue, 2 states; / kg body weight daily up to 400mg, l days, not only did not alleviate the cyanosis, but heavier and the emergence of side effects. Vitamin C have redox index, with the application can reduce the amount of methylene blue, and can enhance efficacy. Merger digestive tract, heart damage and liver dysfunction were given symptomatic treatment. In patients with severe poisoning, give oxygen, proper use of glucocorticoids, liver, diuretic, supportive therapy,[link widoczny dla zalogowanych], prevention of complications, to improve the body resistance to improve the cure rate has an important role.
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