鱼胆中毒致多系统脏器功能衰竭(附23例临床分析)  

Grass carp bile poisoning and multiple system organ failure:Clinical analysis,of 23 cases

作　　者：黄邦汉[1] 陈纪平[1] 李平君[1] 陈少如[2] 许鸿举[2] 

机构地区：[1]广东汕头市中心医院,515031 [2]广东汕头大学医学院

出　　处：《中国危重病急救医学》1993年第1期25-26,共2页Chinese Critical Care Medicine

摘　　要：鱼胆中毒导致多系统脏器功能衰竭(MSOF)为临床和动物实验所证实。我院1984年～1992年间,共收治鱼胆中毒致MSOF患者23例。平均每例脏衰数为2.8个,各脏器功能衰竭发生频率以急肾衰为最高(100%),其它依次为肝、胃肠、心、肺、脑等功能衰竭。本组病例用中西医结合综合措施抢救,治疗结果20例痊愈,3例死亡(均具3脏衰以上患者),病死率13.04%,其中21例急肾衰患者中15例行血透,死亡1例,死亡率6.6%。鱼胆中毒致MSOF的防治原则应是:早期诊断,严密监护,积极救治,预防为主。(1)早期诊断,及时识别龟胆中毒引起多系统脏器功能受损和衰竭早期表现是防治鱼胆中毒致MSOF的关键。(2)加强监护,严密检测是救治成功的重要环节。(3)以中西医结合,早期预防性血透是提高抢救成功率的综合措施。(4)普及民众卫生宣教,禁食鱼胆是预防鱼胆中毒的根本保证。Clinical study and experiments an animals haveindicated that grass carp bile poisoning could lead tomultiple system organ failure(MSOF).23 patients withgrass carp bile poisoning were admitted to our hospitalfrom 1984 to 1992.The average number of failuredorgens or systens was 2.8 among them.Renal failurewas the most commonly seen organ failure(100%)fol-lowed by hepatic,gastrointestinal,cardiac,respiratoryand (?)bral failure in sequence.Treated with inte-grated traditional Chinese and western medicine 20patients survived and 2 died with a mortality rate of13.04% Among the 15 patients who underwenth(?)modialysis,14 survived and 1 died with a mortalityrate of 6.6%.The principles in the treatment and prevention ofMSOF caused by grass carp bile poisoning are:1).Ear-ly recognition is of the utmost importance in pre-venting the organs and systems from-becoming failed.2)Close monitoring plays an important role in in-creasing the rate of su(?)ss.3)Using integrated tradi-tional Chinese and western medicine and hemodialysisin the early stage of the illness are the comprehensiv(?)measures for the successful treatment.4)Spreading thehealth care knowledge to avoid(?)ating fish bile is thefundamental guarantee of the prevention of fish bilepoisoning.

关 键 词：胆汁 多器官衰竭 食物中毒 

分 类 号：R595.705[医药卫生—内科学]