社團法人臺灣臨床藥學會

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【案例報告】有機磷中毒併發吸入性肺炎之案例報告
Organophosphate Intoxication Complicated by Aspiration Pneumonia — Case Report
乙醯膽鹼酯 、有機磷中毒、吸入性肺炎、 acetylcholinesterase, organophosphate intoxication, aspiration pneumonia
張展維Chan-Wei Chang 、江睿玲Ruey-Ling Jiang 、鄭奕帝Yih-Dih Cheng 、張弘育Hung-Yu Chang
1嘉義長庚紀念醫院 藥劑科 、2嘉義長庚紀念醫院 一般內科
一名喝農藥自殺的43歲男性個案,被送至本院急診時,意識不清並表現出毒蕈樣(muscarinic)及菸鹼樣(nicotinic)的中毒症狀,此外,患者乙醯膽鹼酯 活性降低至188 U/L。在確立診斷為有機磷中毒後,即施以洗胃及活性碳治療,而後給予atropine及pralidoxime,病人入院後陸續併發心搏過慢及吸入性肺炎。住院11天後,有機磷中毒症狀消失及吸入性肺炎獲得控制,且乙醯膽鹼酯 值回復至1,000 U/L,情況穩定後出院。
 
A case of a 43-year-old man with acute ingestion of Fenthion—an anticholinesterase insecticide—is reported here. Upon arrival in the Emergency Department, not only were patient’s decreased consciousness and the toxic symptoms of organophosphate intoxication observed, but a very low level of acetylcholinesterase activity (188 U/L) was also measured. After the diagnosis of organophosphate intoxication, the patient was gastric lavaged, and then treated with atropine and pralidoxime. During hospitalization, the patient suffered from complications of bradycardia and aspiration pneumonia. Because aspiration pneumonia was well controlled, the acetylcholinesterase activity was raised to 1,000 U/L, and the toxic symptoms disappeared—the patient was discharged after 11 days.
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