急性有機リン農薬中毒の管理について
Michael Eddleston1, Nick A Buckley, Peter Eyer
1Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, England. eddlestonm@yahoo.com
Lancet (London, England)
|August 21, 2007
まとめ
オーガノフォスファル農薬による自己中毒は,毎年20万人の命を奪っている. アトロピンやオキシメスのような現在の治療には明確なガイドラインがなく,医療管理の改善と死亡率の減少のためにさらなる研究が必要である.
科学分野:
- 毒理学 毒理学 毒理学
- クリニカル・メディシン 臨床医学
- 公衆衛生は公衆衛生である.
背景:
- オーガノフォスファル農薬による自己中毒は,開発途上国における主要な死因であり,死亡率は高い.
- 既存の医療管理戦略は困難で,証拠に基づいた明確なガイドラインがない.
- 農薬の毒性および測定方法の大幅な変動は,比較可能なデータ収集を妨げています.
研究 の 目的:
- オーガノフォスファル農薬中毒の治療を導く限られた証拠をレビューする.
- 効果的な将来の臨床試験を設計するための要因を特定する.
- コア・トリートメントと新しい治療法の最適な投与方法を模索する.
主な方法:
- 有機農薬中毒治療に関する既存の文献のレビュー.
- 治療の有効性やデータの比較性に影響する要因の分析.
- 現在のコンセンサスと新興の治療アプローチの議論.
主要な成果:
- アトロピン,酸素,呼吸器のサポート,および液体による早期蘇生は,改善された組織酸素化のために推奨されます.
- オキシメスの役割は不確実であり,特定の農薬中毒や中程度の症例に潜在的に有益である.
- マグネシウム硫酸などの新しい治療法は有望であるが,より大きな試験が必要である;胃洗浄は患者の安定性を条件とする.
結論:
- アトロピン,オキシメス,ディアゼパムの最適な使用は,何十年もの使用にもかかわらず,不明のままです.
- 治療法を評価するためのランダム化試験が進行中ですが,一部の農薬は現在の治療法に抵抗する可能性があります.
- 特定の農薬の禁止と医療管理の改善は,有機リン中毒による世界的な死亡率を減らすために不可欠です.
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