2021年美国CDC肉毒杆菌中毒临床诊疗指南解读  

Interpretation of clinical diagnosis and treatment guidelines for CDC botulinum poisoning in the United States in 2021

作　　者：孙宝迪 季青峰 俞燕露 杨海婷 孙怡男 申前进 邵旦兵 SUN Baodi;JI Qingfeng;YU Yanlu;YANG Haiting;SUN Yinan;SHEN Qianjin;SHAO Danbing(Department of Emergency,Sir Run Run Hospital,Nanjing Medical University,Nanjing Jiangsu 211100,China)

机构地区：[1]南京医科大学附属逸夫医院急诊医学科,江苏南京211100

出　　处：《中国急救复苏与灾害医学杂志》2022年第2期145-149,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：南京医科大学科技发展基金(编号:NMUB2018298)。

摘　　要：肉毒杆菌中毒是一种以肉毒神经毒素介导的危及生命的感染性疾病,临床罕见,以颅神经麻痹为主要特点,表现为急性对称性下行性迟缓性瘫痪,严重者可发展为四肢无力及呼吸衰竭。肉毒神经毒素主要由革兰阳性厌氧梭状芽孢杆菌(肉毒梭菌)产生,可抑制神经肌肉突触乙酰胆碱的释放。根据肉毒杆菌中毒的途径一般为食源性肉毒杆菌中毒、伤口肉毒杆菌中毒、医源性肉毒杆菌中毒以及吸入性肉毒杆菌中毒。肉毒杆菌中毒的治疗包括对症支持以及注射肉毒杆菌抗毒素,必要时行气管插管和机械通气。对2021年美国疾病预防控制中心(CDC)肉毒杆菌中毒的临床诊疗指南进行解读,以期为国内临床诊疗提供参考。Botulism is a life-threatening infectious disease mediated by botulinum neurotoxin.It is rare in clinic.The main feature of cranial nerve palsy is acute symmetric descending paralysis.Severe cases can develop into weakness of limbs and respiratory failure.Botulinum neurotoxin is mainly produced by gram-positive anaerobic Clostridium botulinum,which can inhibit the release of acetylcholine from neuromuscular synapses.According to the way of botulinum poisoning,it is generally foodborne botulinum poisoning,wound botulinum poisoning,iatrogenic botulinum poisoning and inhalation botulinum poisoning.The treatment of botulism includes symptomatic support,injection of botulinum antitoxin,endotracheal intubation and mechanical ventilation when necessary.In order to provide reference for domestic clinical diagnosis and treatment the clinical diagnosis and treatment guidelines of botulinum poisoning issued by the Centers for Disease Control and Prevention(CDC)in 2021 wan iterpreted.

关 键 词：肉毒杆菌 肉毒神经毒素 美国疾病预防控制中心 临床指南 解读 

分 类 号：R595.9[医药卫生—内科学]