tightness all over the body
Introduction
Introduction The tightness of the whole body is one of the clinical symptoms caused by diseases caused by organophosphorus pesticide poisoning. Nicotinic-like symptoms in the clinical manifestations of organophosphorus pesticide poisoning: when the condition worsens, the whole body is tight, the speech is unclear, the chest, upper limbs, face and neck and even the whole body muscle tremor, chest pressure, heart rate, blood pressure rise In severe cases, breathing paralysis.
Cause
Cause
Organophosphorus pesticides can enter the body through the digestive tract, respiratory tract and intact skin and mucous membranes. Occupational pesticide poisoning is mainly caused by skin contamination. The absorbed organophosphorus pesticides are distributed in various organs in the body, wherein the liver content is the largest, and the brain content depends on the ability of the pesticide to penetrate the blood-brain barrier. The main mechanism of organophosphorus pesticide poisoning is inhibition of cholinesterase activity. The combination of organophosphate and cholinesterase forms phosphorylcholinesterase, which causes the loss of cholinesterase to catalyze the hydrolysis of acetylcholine. The accumulated acetylcholine has two effects on choline: muscarinic and nicotine Like a role.
Examine
an examination
Related inspection
Serum aspartate aminotransferase urine routine blood routine
Acute poisoning according to the time of exposure to a large number of organic phosphorus, clinical manifestations, combined with reduced blood cholinesterase activity. Occupational poisoning reference work environment and skin pollution detection, urine metabolite determination, food contamination caused by poisoning reference residual food or gastric lavage fluid detection and population epidemiology, comprehensive analysis, exclude other diseases before diagnosis.
1. Observed subjects: mild muscarinic, nicotinic or central nervous system symptoms, and whole blood cholinesterase activity is not less than 70%; or no obvious clinical manifestations of poisoning, and whole blood choline The esterase activity is below 705.
2. Acute mild poisoning: After exposure to a large amount of organophosphorus pesticides in a short period of time, symptoms such as dizziness, headache, nausea, vomiting, excessive sweating, chest tightness, blurred vision, weakness, etc. may occur within 24 hours, and the pupil may shrink. Whole blood cholinesterase activity is generally between 50% and 70%.
3. Acute moderate poisoning: In addition to the above-mentioned heavier symptoms, there are fasciculation, dilated pupils, mild dyspnea, salivation, abdominal pain, diarrhea, gait, confusion or confusion. Whole blood cholinesterase activity is generally between 30% and 50%.
4. Acute severe poisoning: In addition to the above symptoms, one of the following conditions can be diagnosed as severe poisoning: (1) pulmonary edema; (2) coma; (3) respiratory paralysis; (4) cerebral edema. Whole blood cholinesterase activity is generally below 30%.
5. Delayed neuropathy: 2 to 3 weeks after the onset of acute severe poisoning symptoms, some cases may have sensory and motor-type peripheral neuropathy, and neuro-electromyography shows neurogenic damage.
Diagnosis
Differential diagnosis
Identification with other organic pesticide poisoning. If the atypical case or medical history is unclear, it should be noted that other diseases, such as other food poisoning, poisonous poisoning and Japanese encephalitis, should be excluded. Blood cholinesterase activity can be identified.
