不明原因中毒1例诊治分析  

Analysis of diagnosis and treatment of a case of intoxication of unknown cause

作　　者：刘思佳 徐宝丽 唐勇[1] 罗晓佳[1] Liu Sijia;Xu Baoli;Tang Yong;Luo Xiaojia(Department of Emergency,Chengdu Second People's Hospital,Chengdu 610000,Sichuan,China)

机构地区：[1]成都市第二人民医院急诊科,四川成都610000

出　　处：《实用检验医师杂志》2023年第2期209-211,共3页Chinese Journal of Clinical Pathologist

摘　　要：目的报告1例不明原因中毒患者的诊疗过程,分析其临床表现和中毒原因,为临床对不明原因中毒患者的确诊及治疗提出讨论与警示。方法成都市第二人民医院于2023年2月22日收治1例以心律失常为主要表现的中毒患者,采用临床检查、病史分析及多方会诊的方法评估患者病情,制定治疗方案,抢救患者生命。结果患者明确服用何首乌和天麻炖汤后出现全身症状,尤以心律失常为主,但具体临床表现和服用中药材所致不良反应并不相符,根据病史分析、临床表现、检查结果及会诊结果,考虑乌头碱中毒,进一步予以体外膜肺氧合(ECMO)、安置心脏起搏器、血液净化、保护器官功能处理,但患者病情危重,最终死亡。结论乌头碱中毒以心律失常为主要表现,无相关基础疾病患者出现心律失常,应警惕中毒。Objective To report the diagnosis and treatment process of one case with unexplained poisoning,analyze the clinical manifestations of poisoning causes,and put forward discussion and warning for the diagnosis and treatment of patients with unexplained poisoning in clinical practice.Methods A toxic patient with arrhythmia as the main manifestation was admitted in Chengdu Second People's Hospital on February 22,2023.Clinical examination,history analysis and multi-party consultation were used to evaluate the patient's condition,and treatment plan was given to save the patient's life.Results The patient showed systemic symptoms after taking Polygonum multiflora and Rhizoma Gastrodiae decoction,especially arrhythmia,but the specific clinical manifestations were inconsistent with the adverse reactions caused by taking Chinese herbal medicines.According to the medical history analysis,clinical manifestations,examination results and consultation results,further treatment was given to aconitine poisoning,including extracorporeal membrane oxygenation(ECMO),placement of cardiac pacemaker,blood purification and protection of organ functions.But the patient became critically ill and eventually died.Conclusions The main manifestation of aconitine poisoning is arrhythmia.Patients without related underlying diseases have arrhythmia and should be alert to poisoning.

关 键 词：中毒 何首乌 天麻 乌头碱 

分 类 号：R595.4[医药卫生—内科学]