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摘要: 目的：总结急性重症乌头碱中毒的救治体会。方法：回顾分析2010-01-2014-06我院收治的12例急性重症乌头碱中毒患者的临床资料。结果：本组12例均表现为不同程度的神经、心血管和胃肠道毒性症状，心电图异常主要为早期（24 h内）出现窦性心动过速、心动过缓以及室性心动过速和室颤等室性心律失常，7例出现器官功能障碍，其中低血压或心源性休克3例，呼吸困难或抑制2例，意识障碍1例，肾功能衰竭1例。本组在常规救治基础上给予血液灌流2~4次，平均（3.5±0.5）次；血液灌流时间为2~8 h，平均（6.0±2.0） h；另外1例肾功能衰竭患者联合血液透析维持1周。最终11例救治成功，心律失常得以纠正，住院时间为4~14 d，平均（5.5±1.5） d；1例死亡，死于室性快速型心律失常。结论：急性乌头碱中毒以神经、心血管和胃肠道毒性反应为主，严重者可出现器官功能障碍。血液灌流通过清除毒性物质、改善内环境紊乱、保护重要脏器，有助于提高重症患者的救治成功率。Abstract: Objective: To summarize the treatment experience of severe acute aconitine poisoning.Method: The clinical data of 12 patients with severe acute aconitine poisoning from January 2010 to June 2014 were retrospectively analyzed.Result: All patients showed different degrees of neurological,cardiovascular and gastrointestinal toxicity symptoms.The abnormal ECG were mainly early (24) appeared ventricular arrhythmia such as sinus tachycardia,bradycardia and ventricular tachycardia and ventricular fibrillation.7 patients occured organ dysfunction,including 3 patients with hypotension or cardiogenic shock,2 cases accompanied with dyspnea or suppression,1 cases accompanied with disturbance of consciousness,1 cases with renal failure.Hemoperfusion were given on the basis of conventional therapy.This group of 12 cases were given hemoperfusion 2~4 times with an average of (3.5±0.5) times,hemoperfusion time was 2~8 h with an average of (6.0±2.0) h.One case of renal failure combined hemodialysis lasts 1 week.Eleven patients treated successfully and the cardiac arrhythmias were corrected.One case died of serious arrhythmia,respiratory failure and shock caused by the cycle of failure.The length of hospital stay was 4~14 d with an average of (5.5±1.5) d.Conclusion: Severe acute aconitine poisoning mostly associated with a combination of cardiovascular,neurological,and gastrointestinal toxicity,also can caused organ dysfunction.Hemoperfusion should be advocated due to removing toxic substances,improving the internal environment disorder,protecting important viscera and improving the successful rate.
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Key words:
- aconitine /
- poisoning /
- hemoperfusion
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