(李彩侠)急性阿维菌素中毒19例临床治疗分析.docVIP

急性阿维菌素中毒19例临床治疗分析 李彩侠 杨一红 【摘要】目的 分析19例阿维菌素中毒抢救成功的经验，用于更进一步指导急性阿维菌素中毒的临床救治。方法 将20～201年的19例急性阿维菌素中毒病例进行评估分析。结果 阿维菌素中毒者均有中枢神经系统症状和肌酸激酶明显升高，肝肾功能无明显损害。尽快彻底清除毒物(洗胃、导泻)，尽早血液净化和控制抽搐，及时辅助机械通气及保护重要脏器等综合治疗。19例病人全部成功救治。结论 阿维菌素毒性较强，中毒后导致中枢神经系统损害和全身肌肉抽搐，虽无特效解毒剂，及时合理采取积极对症支持治疗，仍可成功地治愈中毒患者。 【关键词】阿维菌素中毒血液净化呼吸机肌酸激酶【英文摘要】Objective – Analyse the successful experience of the emergency treatment for the 19 acute Avermectin -poisoned cases for the purpose of providing further guidance on the clinical emergency treatment for the acute Avermectin– poisoned patients. Method – The assessment analysis shall be based on the 19 cases of the acute Avermectin poisoned patients during the years 2011and 2013. Results – The Avermectin-poisoned patients have all been found suffering from the central nervous system symptoms with significantly higher creatine kinase but with no obvious damage to the liver and kidney function. Comprehensive treatment measures had been taken immediately to thoroughly elimination the poison (through gastric lavage and catharsis), to purify blood, to bring convulsions under control and to protect the vital organs assisted with respirator in a timely manner. All the 19 patients were successfully brought out of danger. Conclusion – The toxicity of Avermectinis very strong which, after getting poisoned, can cause both damage to the central nerve system and general muscular twitch. Although there is no specific antidote, rational and positive measures taken in a timely manner to suit the remedy to the poisoned cases shall be of help to save the poisoned patients successfully. [Key words] Avermectin, Poisoned, Blood Purification, Respirator and Creatine Kinase. 近年来，随着各类农药在农业生产的广泛应用，农药中毒频频发生，且种类多、成分复杂，给临床医生救治中毒病例带来一定的困难。阿维菌素即是其中的一种新型的农药中毒类别。我院自20年至，共收治阿维菌素急性中毒病人19例，经过我们积极的救治，19例病人全部成功治愈，现总结分析如下： 临床资料 1.1 临床资料 我科20年1月～201年10月共收治急性阿维菌素中毒病人19例，其中男性8例，女性11例，年龄最大71岁，最小16岁，平均年龄41±2岁，所有病人均为口服自杀中毒。中毒时间在2小时～3天，其中中毒时间为2小时2例，中毒时间为4小时5例，中毒时间为5小时4例，中毒时间为7小时2例，中毒时间为12小时1例，中毒时间为3天1例。服毒量在20ml