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山东大学学报(医学版)

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婴幼儿毒鼠强中毒特点及血液灌流疗效观察

孙文秀, 王学禹, 温兆春, 高玉兴, 王如明   

  1. 山东大学山东省立医院小儿神经科, 山东 济南 250021
  • 收稿日期:2005-09-09 修回日期:1900-01-01 出版日期:2006-05-24 发布日期:2006-05-24
  • 通讯作者: 孙文秀

SUNWen-xiu,WANGZue-yu,WENZhao-chun,GAOXing-yu,,WANGRu-ming   

  • Received:2005-09-09 Revised:1900-01-01 Online:2006-05-24 Published:2006-05-24
  • Contact: SUNWen-xiu

摘要: 目的:探讨≤3岁婴幼儿毒鼠强中毒特点,血液灌流治疗疗效及注意事项。方法:采用气相色谱法测定患儿血中毒鼠强成分,根据病情将42例患儿分为轻、中、重3组,对其血中毒鼠强浓度、心肌酶谱测定结果与病情程度进行比较,并分析血液灌流的疗效及不良反应。结果:误诊26例,惊厥持续状态、昏迷22例;重度中毒组心肌酶谱明显高于中度中毒组(P<0.05);血中毒鼠强浓度≥80?ng/ml显示病情严重;血液灌流组预后明显好于非血液灌流组(P<0.05)。与治疗相关的严重并发症5例。结论:婴幼儿毒鼠强中毒易误诊,惊厥持续状态、昏迷症状突出;病情越重,心肌酶谱及毒鼠强浓度越高;血液灌流疗效确切,但应注意可能伴随的不良反应。

Abstract: To explore the characteristics of tetramine poisoning within 3 years old, the therapeutic effects and advertent problems of hemoperfusion therapy. Methods: The serum tetramine composition was determined by gas chromatograph method. The clinical data of 42 infants and toddlers were analyzed. They were divided into mild, moderate and severe groups. The serum levels of tetramine and myocardial enzymes were compared with its severity. The effects and adverse reactions of hemoperfusion therapy were summarized. Results: Tuentysix cases were misdiagnosed, 22 cases were in status epilepticus and coma. The levels of myocardial enzymes in the severe group were obviously higher than those of moderate group (P<0.05). The clinical state was worse when the serum tetramine concentration was higher than or equal to 80 ng/ml. The prognosis in the hemoperfusion group was obviously better than the nonehemoperfusion group(P<0.05). Severe complications were found in 5 cases. Conclusion: Tetramine poisoning in infants and toddlers is easily misdiagnosed, especially in status epilepticus and coma. The severity is positively associated with the increase of myocardial enzymes and tetramine concentration. Hemoperfusion is effective, however, it may have severe consequences.

Key words: Tetramine, Tetramine, Poisoning, Poisoning, Hemoperfusion, Hemoperfusion, Myocardial enzyme, Myocardial enzyme, Infants , Infants

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