乌头碱急性中毒患者的心电图特点及意义  

Characteristics and significances of ECG in the patients with acute aconitine poisoning

作　　者：李玲文[1] 邱俏檬[2] 吴斌[2] 杜林林[2] 赵初环[2] 李景荣[2] 

机构地区：[1]温州医学院附属第一医院心电图室,325000 [2]温州医学院附属第一医院急诊科,325000

出　　处：《中国急救医学》2007年第2期124-126,共3页Chinese Journal of Critical Care Medicine

基　　金：浙江省中医药管理局资助项目(No.2006C094)

摘　　要：目的探讨乌头碱急性中毒患者的心电图特点及意义。方法1998—01—2006—08间我们先后成功抢救乌头碱急性中毒患者20例，总结其临床资料，分析心电图的特点及抢救治疗后的变化。结果20例患者均发生心律失常，12例为紊乱性心律，其中6例为频发室性期前收缩、室性期前收缩二联律或三联律，6例以多源多形性室早、室速为主，其中2例多次出现室颤。8例分别为频发室性期前收缩、房性期前收缩、窦性心动过缓、窦性心动过速、Ⅰ度房室传导阻滞、Q—T间期延长。频发多源室性心律失常、室速、室颤均出现在临床重度中毒患者中，其中7例重度患者行急诊血液净化治疗，心律失常迅速减少，5～8h心电图转为正常。所有患者治愈出院。结论乌头碱急性中毒患者的心电图表现多样化，以室性心律失常最常见，其心律失常严重性直接反映临床急性中毒的严重程度，早期进行血液灌流治疗可迅速纠正心律失常，使心电图恢复正常。Objective To study the characteristics and siguificances of electrocardiogram （ECG） in the patients with acute aconitine poisoning. Method To collect and analyse the data of ECG of 20 aconitine poisoning patients who were successfully saved in our emergency room from January 1998 to August 2006. Resuits All 20 cases showed arrhythmias under their ECGs. 12 cases were chaotic ventricular arrhythmias including 6 cases of frequent ventricular premature beats, bigeminy or trigeminy of ventricular premature beats, 6 cases of multifocal polymorphic ventricular premature heats, ventricular tachycardia and 2 cases of ventricular fibrillation. The other 8 cases were recurrent attacks of ventricular premature beat, atrial premature beat, sinus bradycardia, sinus tachycardia, first degree atrioventricular block, lengthening of Q -T interval. The serious arrhythmias of frequent multifocal ventricular arrhythmia, ventricular tachycardia and ventricular fibrillation occurred in severe aconitine poisoning patients. 7 severe cases were treated with blood purification in an emergency and their arrhythmias were corrected rapidly within 5 - 8 hours. All 20 patients were cured. Conclusion The study shows the diversity of arrhythmia in acute aconitine poisoning patients and ventricalar arrhythmia is the most common type. We can judge the severity of poisoning directly by the severity of arrhythmias under the ECG. The arrhythmia can be cured rapidly and ECG can be normalized soon by early treatment of blood purification.

关 键 词：乌头碱 中毒 心电图 

分 类 号：R595.4[医药卫生—内科学]