毒蕈中毒并发多器官功能衰竭1例报告并文献复习

doi:10.13481/j.1671-587x.20170239

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (02): 412-415.doi: 10.13481/j.1671-587x.20170239

毒蕈中毒并发多器官功能衰竭1例报告并文献复习

葛安琪, 吴昆哲, 徐晓华

吉林大学中日联谊医院肾内科, 吉林长春 130033

收稿日期:2016-04-25 出版日期:2017-03-28 发布日期:2017-03-31
通讯作者: 徐晓华,副教授,副主任医师(Tel:0431-84995080,E-mail:573472622@qq.com) E-mail:573472622@qq.com
作者简介:葛安琪(1992-),女,山东省聊城市人,在读医学硕士,主要从事消化内科疾病诊疗方面的研究。
基金资助:
吉林省科技厅自然科学基金资助课题（20160101017JC）

Mushroom poisoning complicated with multiple organ disfunction syndrome:A case report and literature review

GE Anqi, WU Kunzhe, XU Xiaohua

Department of Nephrology, China-Japan Union Hospital, Jilin University, Changchun 130033, China

Received:2016-04-25 Online:2017-03-28 Published:2017-03-31

摘要/Abstract

摘要： 目的：报道1例应用血液净化治疗毒蕈中毒并多器官功能衰竭病例，探讨毒蕈中毒并发多器官功能衰竭的救治方法及原理。方法：患者接受血浆置换，隔日1次，联合血液灌流及血液透析序贯血液净化治疗，并辅以激素冲击、抗感染等积极对症支持治疗。结果：治疗后患者脱离生命危险，生命体征平稳，肝功能、肾功能和凝血等均有改善。结论：早期应用血浆置换联合血液灌流及血液透析序贯血液净化可有效治疗毒蕈中毒并发多器官功能衰竭及血栓性微血管病，并改善预后。

关键词: 多器官功能衰竭, 序贯血液净化, 毒蕈中毒, 血栓性微血管病

Abstract: Objective: To report one case of mushroom poisoning complicated with multiple organ disfunction syndrome treated by sequential blood purification,and to explore the treatment method and principle of mushroom poisoning complicated with multiple organ disfunction syndrome. Methods: Hemoperfusion was performed in the patient,once every other day,combined with sequential blood purification of hemoperfusion and hemodialysis, and supplemented by hormone therapy and anti-infection. Results: The patient was out of danger,and the vital signs were stable;liver function,kidney function and blood routine were recovered. Conclusion: Early application of hemoperfusion combined with sequential blood purification can effectively treat the mushroom poisoning complicated with multiple organ disfunction syndrome and thrombotic microangiopathy,and improve the prognosis.

Key words: sequential blood purification, thrombotic microangiopathy, mushroom poisoning, multiple organ disfunction syndrome

中图分类号:

R595.7

葛安琪, 吴昆哲, 徐晓华. 毒蕈中毒并发多器官功能衰竭1例报告并文献复习[J]. 吉林大学学报(医学版), 2017, 43(02): 412-415.

GE Anqi, WU Kunzhe, XU Xiaohua. Mushroom poisoning complicated with multiple organ disfunction syndrome:A case report and literature review[J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 412-415.

参考文献

[1] 卯晓岚.中国毒菌物种多样性及其毒素[J].菌物学报,2006,25(3):345-363.
[2] Ward J,Kapadia K,Brush E,et al.Amatoxin poisoning:case reports and review of current therapies[J].Emerg Med,2013,44(1):116-121.
[3] 兰祥莉.血液透析抢救药物中毒及毒物中毒的护理[J].大家健康:学术版,2012,6(7):53.
[4] Ghannoum M,Gosselin S.Enhanced poison elimination in critical care[J]. Adv Chronic Kidney Dis, 2013, 20(1):94-101.
[5] Williams ME,Balogun RA.Principles of separation:indications and therapeutic targets for plasma exchange[J].Clin J Am Soc Nephrol,2014,9(1):181-190.
[6] 曾俊峰.血液灌流急救53例重症中毒患者临床观察[J].当代医学,2015,21(20):68-69.
[7] 陈运超,李婉媚,李小强.血浆置换治疗急性白毒伞中毒65例临床分析[J].海南医学,2013,4(7):954-956.
[8] Ward J,Kapadia K,Brush E,et al.Amatoxin poisoning:Case reports and review of current therapies[J].Emerg Med,2013,44(1):116-121.
[9] 王辉,张彧,龚平,等.序贯性血液净化治疗毒蕈中毒并多器官功能损害的临床观察[J].中外健康文摘,2012,9 (23):69.
[10] 毕喜兵,牛明华.蘑菇中毒肝脏损害的治疗体会[J].中国医药指南,2014,10(7):19-21.
[11] 韩东锋,孙芳芳,武艳萍,等.血液滤过抢救毒蕈中毒致多脏器衰竭1例[J].中国老年学杂志,2012,32 (1):173-174.
[12] Vanooteghem S,Arts J,Decock S,et al.Four patients with Amanita Phalloides poisoning[J].Acta Gastroenterol Belg,2014,77(3):353-356.
[13] Colak S,Kandis H,Afacan MA,et al.Assessment of patients who presented to the emergency department with mushroom poisoning[J].Hum Exp Toxicol,2015,34(7):725-731.
[14] 张黎光,李俊志,祁鹏,等.毒蕈中毒及治疗方法研究进展 [J].中国食用菌,2014,33(5):1-5.
[15] 于峰,赵明辉. 血栓性微血管病诊治进展 [J].实用医院临床杂志,2012,9(2):8-10.
[16] 王兆钺.血栓性微血管病鉴别诊断与治疗的进展 [J].中华血液学杂志,2015,36(3):254-257.
[17] Apperley S,Kroeger P,Kirchmair M,et al.Laboratory confirmation of Amanita smithiana mushroom poisoning[J].Clin Toxicol(Phila),2013,51(4):249-251.
[18] 陈桂花.17例急性毒蕈中毒患者的临床分析[J].求医问药(下半月),2013,11(10):52-53.
[19] 夏志伟,丁红涛,李永胜,等.血液灌注联合持续床边血液滤过抢救重度有机磷中毒的临床疗效[J].武汉大学学报:医学版,2013,32(2):290-292.
[20] Mengs U,Pohl RT,Mitchell T.Legalon^® SIL:the antidote of choice in patients with acute hepatotoxicity from amatoxin poisoning[J].Curr Pharm Biotechnol,2012,13(10):1964-1970.

毒蕈中毒并发多器官功能衰竭1例报告并文献复习

Mushroom poisoning complicated with multiple organ disfunction syndrome:A case report and literature review

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 1

Metrics

本文评价

推荐阅读 0