16例急性三氯异氰尿酸中毒心电图分析及临床处理  

作　　者：周世方 李长罗 杨志伟 丁宁 

机构地区：[1]南华大学附属长沙中心医院,410004

出　　处：《浙江临床医学》2023年第8期1200-1202,共3页Zhejiang Clinical Medical Journal

基　　金：湖南省卫生计生委课题项目(20180468)。

摘　　要：目的分析16例急性三氯异氰尿酸中毒患者心电图特点及临床处理。方法收集2020年8月本院急诊科收治的16例急性三氯异氰尿酸中毒患者临床表现、辅助检查、治疗方法。结果16例患者中有眼部不适、胸闷、头晕/头痛、恶心、鼻干等一个或多个症状,心电图7例窦性心动过缓,11例窦性心律不齐,4例电轴右偏,2例早期复极化,1例频发室性早搏。入院后均予鼻导管氧气吸入,根据患者症状分别予妥布霉素地塞米松滴眼液滴眼,地塞米松注射液10 mg静脉滴注,注射用磷酸肌酸钠1.0护心、门冬氨酸钾镁注射液补镁、10%氯化钾注射液补钾等治疗。15例经留院观察后恢复出院;1例因频发室性早搏住院1周出院。结论急性三氯异氰尿酸中毒患者除出现眼部不适、鼻干等局部刺激症状和胸闷、头晕/头痛、恶心等全身症状外,早期心电图大多有异常改变,经过积极临床干预预后良好。Objective To analyze the of the ECG characteristics and clinical treatment of 16 patients with acute trichloroeisocyanurate poisoning.Methods 16 cases of acute trichloroisocyanuric acid poisoning in the emergency department of our hospital in August 2020 were collected.Results Among the 16 patients,one or more of them had eye discomfort,chest tightness,dizziness/headache,nausea,dry nose and other symptoms.ECG showed sinus bradycardia in 7 cases,sinus arrhythmia in 11 cases,right axis deviation in 4 cases,early repolarization in 2 cases,and frequent ventricular premature beat in 1 case.They were given tobramycin dexamethasone eye drops,dexamethasone injection 10 mg intravenous drip,creatine phosphate 1.0 heart protection,magnesium supplement and potassium supplement according to the symptoms.15 cases recovered and discharged from hospital after the observation,and 1 case was discharged from hospital for 1 week due to frequent ventricular premature beat.Conclusion Patients with acute trichloroisocyanuric acid poisoning have not only local irritation symptoms such as eye discomfort,dry nose and systemic symptoms such as chest tightness,dizziness/headache and nausea,but also abnormal ECG changes in the early stage.After active clinical intervention,the prognosis is good.

关 键 词：三氯异氰尿酸 中毒 心电图 临床处理 

分 类 号：R595[医药卫生—内科学]