Mental disorders due to pesticide poisoning
Introduction
Introduction to mental disorders caused by pesticide poisoning Organophosphorus pesticides are the most widely used agricultural pesticides. They have many kinds of insecticides, strong insecticidal ability and wide spectrum of insecticides. They have been widely used in agricultural production, but they are more toxic to humans and animals. The cause of poisoning caused by organic phosphorus is mainly When using, the operating procedures are not observed, or the protective equipment is imperfect during production and use. The way to invade the human body is mainly through the respiratory tract and the skin. Those who enter the digestive tract are often mistaken or suicidal. When organic phosphorus enters the body, it inhibits the activity of cholinesterase in the body, causing excessive excitation of the cholinergic nerve, leading to dysfunction of the nervous system. Psychiatric symptoms and signs and symptoms of the nervous system appear. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people. Mode of infection: non-infectious Complications: pulmonary edema, brain edema
Cause
Causes of mental disorders caused by pesticide poisoning
(1) Causes of the disease
1. Psychic disorders caused by organophosphate poisoning The cause of poisoning caused by organic phosphorus is mainly due to the failure to observe the operating procedures or the imperfect production protection equipment during use. The way to invade the human body is mainly through the respiratory tract and skin, and the gastrointestinal tract enters. Mostly, it is accidental or suicide. The organic phosphorus enters the body and combines rapidly with cholinesterase to form phosphorylcholinesterase. The activity of cholinesterase in the body is inhibited, and the effect of decomposing acetylcholine is lost. At the same time, a large amount of acetylcholine is involved. Accumulation in the body, causing excessive excitation of cholinergic nerves, leading to nervous system dysfunction, clinically produced a series of mental, neurological symptoms and signs.
2. Mental disorders caused by organotin poisoning. Organotin compounds can be highly toxic in the manufacturing process. Since organotin is a fat-soluble liquid, it can be volatilized at normal temperature, and can invade the body through the respiratory tract, intact skin and gastrointestinal tract. , leading to nervous system dysfunction, resulting in a series of neurological symptoms and signs.
(two) pathogenesis
Organic phosphorus invades the human body through the respiratory tract, skin or digestive tract and rapidly combines with cholinesterase to form phosphorylcholinesterase. This process inhibits the activity of cholinesterase in the body and loses the effect of decomposing acetylcholine. At the same time, a large amount of acetylcholine accumulates in the body, causing excessive excitation of cholinergic nerves, leading to disorders of the nervous system and brain function, and clinically producing a series of symptoms and signs.
Organotin compounds can be highly toxic in the manufacturing process. Because they are fat-soluble liquids, they can be volatilized at normal temperature. They can invade the body through the respiratory tract, intact skin and gastrointestinal tract. The organotin compounds are also different in toxicity depending on the alkyl group. The difference is that triethyltin is the most toxic. Animal experiments have shown that organotin is a severe central nervous system poison, which can inhibit the oxidative phosphorylation of brain cell mitochondria, causing disorder of normal brain function and producing neuropsychiatric symptoms.
Prevention
Prevention of mental disorders caused by pesticide poisoning
The mental disorder caused by pesticide poisoning is completely preventable. As long as the production system and the use regulations are strictly observed, prevention and prevention can prevent poisoning and mental symptoms. However, for women who are weak, sick, elderly, pregnant or lactating, and minors, do not work in the management and use of pesticides. When applying pesticides in the field, the operating procedures must be strictly observed. Wear long-sleeved clothes and trousers, hats and latex gloves. When spraying, stand on the wind and back down and spray. Do not smoke during the operation, do not eat, do not drink water, do not wipe your face and eyes with contaminated hands. After work, take a bath with soap and change clothes. Contaminated clothing should be washed with 5% alkaline water for one or two hours before washing. The remaining small amount of liquid medicine and scrubbing equipment should be buried deep underground. In the event of pesticide poisoning, if it is oral poisoning, immediately gastric lavage, while vomiting, and detoxification using drugs. If inhalation is poisoned when spraying pesticides, immediately remove the poisoned environment, quickly remove the contaminated coat, and rinse the contaminated area with soapy water and running water. If the symptoms are severe, they will be taken to the hospital for emergency treatment immediately after initial treatment. Prevent mental disorders caused by pesticide poisoning.
Complication
Psychic disorders caused by pesticide poisoning Complications pulmonary edema cerebral edema
(1) Early rescue due to severe inhibition of cholinesterase, pulmonary edema, cerebral edema and respiratory and circulatory failure.
(2) There is a rebound in the later stage of rescue, which is caused by incomplete gastric lavage or partial withdrawal of atropine. The cause of sudden death in the recovery period is not fully understood, and some are caused by complications or toxic damage in the heart. Therefore, the focus of control is on detoxification and detoxification.
Symptom
Symptoms of mental disorders caused by pesticide poisoning Common symptoms Appetite deficiency, muscarinic symptoms, drowsiness, convulsions, depression, hooliganism, itching, nausea, mental disorders
1. Mental disorders caused by organophosphate poisoning
(1) Psychiatric symptoms: The psychiatric symptoms of organophosphorus poisoning are complex and variable, occurring in a few days to several tens of days after acute poisoning, showing the following symptoms:
1 cerebral weakness syndrome: in mild or chronic poisoning, mainly manifested as headache, dizziness, head-swelling head swelling, attention can not concentrate, memory loss, insomnia and more dreams, and some appear fatigue and lethargy.
2 sputum-like episodes and other snoring-like symptoms: After acute poisoning, some patients may have snoring-like episodes, usually one episode once a day, and one episode one episode, individual patients have timed seizures, each episode may For a few minutes to a few hours, snoring episodes often manifest as emotional outbursts, paralysis, sputum or snoring aphasia, and sensory disturbances such as darkness and deafness.
3 Excited state: The performance is yelling at the patient, crying and laughing, laughing when crying, increasing speech, running around without purpose, and some may be accompanied by disturbance of consciousness, forgotten afterwards.
4 epileptic seizures: a typical systemic episode can occur, and restlessness occurs after the attack.
5 Others: such as depression or hallucinatory paranoia syndrome, follow-up observation can appear suspected syndrome.
(2) Neurological symptoms and signs: visible in acute poisoning:
1 muscarinic symptoms: such as lack of appetite, nausea and vomiting, abdominal pain, diarrhea, sweating and chest tightness, palpitations, blurred vision.
2 nicotinic symptoms: such as muscle jump, muscle spasm, convulsions, epileptic seizures, numbness of the extremities, pain in the extremities, decreased tactile sensation, etc., early differentiation of the diagnosis is more important, dilated pupils, increased glandular secretion and muscle fibers Curled up.
2. Mental disorders caused by organotin poisoning
Similar to organic mercury, organic lead, etc., can be divided into three types:
(1) cerebral weakness syndrome: accompanied by autonomic nervous disorder, and may have loss of appetite, nausea and vomiting.
(2) Toxic encephalopathy: finger tremors, hyperreflexia, etc. may occur.
(3) Allergic reactions: contact dermatitis, itchy skin, etc. may occur.
Examine
Examination of mental disorders caused by pesticide poisoning
Compliance with all types of pesticide poisoning laboratory tests positive changes.
Some people have developed EEG tests on dichlorvos synthetic workers and dichlorvos, and melamine in the packaging group. Some of them showed mild abnormalities and no localized changes. In order to explain the relationship between poisons and EEG, they separately Normal people, neurosis patients and workers underwent EEG examinations. The results were statistically significant, indicating a significant difference between organophosphorus and organophosphorus workers.
The North Medical Occupational Diseases Teaching and Research Group conducted an EEG observation on patients with acute organophosphorus pesticide acute poisoning. It can be detected within 2 to 3 days of acute poisoning: it can be a moderate abnormal EEG; the brain wave is mainly composed of low-three medium-amplitude waves. A delta wave group with paroxysmal middle amplitude irregularities sometimes has a high amplitude spine slow wave; or a mild abnormal electroencephalogram; only a paroxysmal medium amplitude amplitude wave appears, with a faster condition after treatment Recovery, EEG also returned to normal, indicating that the effect of organic phosphorus on brain electrical activity is reversible, and is basically parallel with the disappearance of symptoms, no poison has a significant sustained effect on EEG.
Diagnosis
Diagnosis and diagnosis of mental disorders caused by pesticide poisoning
Diagnostic principles for patients with clinical manifestations of disturbance of consciousness, mental retardation or amnesia syndrome should take into account the possibility of organic mental disorders, but mental disorders alone cannot be used as a qualitative or localized diagnosis of organic psychosis. The etiology, the diagnosis of taxonomy, and the establishment of a diagnosis must have the following points:
1. There is a basis for pesticide poisoning, and pesticide poisoning is established based on medical history, occupation, and environment.
2. The emergence of psychiatric symptoms is related to the progress of pesticide poisoning, and it is improved with the relief of pesticide poisoning or worsened by its aggravation.
3. Positive basis for laboratory tests with pesticide poisoning.
Psychiatric symptoms cannot be attributed to other mental illnesses, ie, other diseases that cause conscious and mental disorders.
