Objective: To sum up the experience of treating patients suffering from organophosphorous pesticide poisoning either through skin or through gastrointestinal tract.
Methods: The cholinesterase activity was less than 0.50 in all patients. They were divided into two groups: poisoning through skin (skin group) and by gastrointestinal route (gastrointestinal group). The number of poisoning through skin or gastrointestinal tract was 34 (19 cases of middle degree and 15 cases of severe degree) and 50 (22 cases of middle degree and 28 cases of severe degree), respectively. The blood cholinesterase activities were determined during the disease course, the clinical symptoms and signs were recorded, and the quantity of atropine used for treatment in respective group was also recorded.
Results: There were no difference in the cholinesterase activities at the same degree between two groups before treatment (P>0.05). But the symptoms of the patients in gastrointestinal group were more serious than in skin group. The cholinesterase activities of the patients in the skin group were higher significantly than that in the gastrointestinal group at 24, 48 and 72 hours after treatment (P<0.05 or P<0.01). The total amount of atropine to achieve atropinization was less in the skin group than that of the gastrointestinal group. The time for restoration of cholinesterase activity was shorter in skin group than the gastrointestinal group (both P<0.01).
Conclusion: With the same level of enzymatic activity of cholinesterase, the symptoms of the patients poisoned via gastrointestinal tract are more serious than poisoning through skin, and the quantity of atropine is used very much more. Reactivation of the cholinesterase is earlier in patients poisoned by skin route.
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