急性乌头硷中毒35例抢救体会  

Emergency treatment of acute aconitine poisoning: an analysis of 35 cases

作　　者：李志敏 

机构地区：[1]云南省丽江市人民医院,云南丽江674100

出　　处：《心血管病防治知识（学术版）》2013年第3期46-48,共3页Prevention and Treatment of Cardiovascular Disease

摘　　要：目的分析急性乌头硷中毒抢救效果与临床体会。方法 2006年10月-2012年10月我科共收治35例乌头硷中毒患者,均经洗胃、使用阿托品和利多卡因治疗,部分症状严重患者同时使用胺碘酮等进行治疗,2例患者行200～360焦耳除颤方式治疗。结果 35例乌头硷中毒患者中,32例成功治愈。3例死亡,均为男性,为误服草乌药酒患者;2例患者出现顽固性室性心动过速及室颤,2例患者均行200～360焦耳除颤6至7次,后转为窦性心律仅可维持2～5min,最终死于心跳停止;5例出现尖端扭转性室速患者,1例到医院第一次心电图就出现尖端扭转性室速,经抗心律失常治疗,半小时心跳停止复苏不成功死亡。4例患者均痊愈出院。总治愈率为91.43%,无并发症发生。结论发生急性乌头硷中毒后,及时予以抢救,进行抗心律失常治疗,防止并发症发生,并对症用药加强治疗,以利于成功挽救患者生命。Objective To analyze the effect of emergency treatment of acute aconitine poisoning and the relevant clinical experience. Methods Thirty-five patients with aconitine poisoning were admitted to our department from October 2006 to October 2012. All the patients were treated by gastric lavage and received treatment with atropine and lidocaine, and some severe cases received amiodarone as an addition; 2 patients underwent 200-360-J defibrillation. Results Among the 35 patients, 32 were cured, and 3 died, all male, due to drinking of Radix Aconiti kusnezoffii wine. Two patients had refractory ventricular tachycardia and ventricular fibrillation; both returned to sinus rhythm after 6-7 times of 200-360-J defibrillation, but it maintained for only 2-5 min, and they finally died of cardiac arrest. Five cases developed torsade de pointes （TdP） ; of them, 1 case, who had TdP on the first electrocardiogram, received antiarrhythmic treatment, but died of cardiac arrest 0.5 h later; the other 4 were discharged after being cured. The overall cure rate was 91.43%, and no complication was found. Conclusion When acute aconitine poisoning occurs, emergency treatment should be provided in time, including antiarrhythmic treatment, complication prevention, and symptomatic medication, so as to save the patient＇s life successfully.

关 键 词：急性 乌头硷中毒 抢救 体会 

分 类 号：R595.3[医药卫生—内科学]