REMEDI——一种新的药物自动分析仪

美国伯乐(Bio-Rad)公司研制的自动药物分析仪REMEDI根据液相色谱原理,在30min内可对病人血清、尿液中300种以上药物及代谢产物进行定性、半定量分析,同时还可对一些药物进行定量分析。该机可用于急诊药物中毒病人快速诊断,滥用药物诊断,毒品、麻醉品、兴奋剂检查,药品质     

纳洛酮在一氧化碳中毒急诊抢救中的临床价值与效果分析

目的:探究纳洛酮在一氧化碳中毒急诊抢救中的临床价值与效果.方法:选取我院2016年2～12月一氧化碳中毒患者86例根据数字随机表分为对照组、纳洛酮组各43例.对照组用常规治疗;纳洛酮组在对照组基础上给予纳洛酮治疗.比较两组一氧化碳中毒治疗效果;苏醒时间、住院时间;后遗症发生率.结果:纳洛酮组一氧化碳中毒治疗效果比对照组高,P<0.05;纳洛酮组苏醒时间、住院时间比对照组短,P<0.05;纳洛酮组后遗症发生率比对照组低,P<0.05.结论:纳洛酮在一氧化碳中毒急诊抢救中的临床价值与效果确切,可缩短苏醒时间和住院时间,减少后遗症,改善预后,值得推广.     

早期高压氧治疗一氧化碳中毒212例临床分析

<正>急性一氧化碳中毒是最常见的生活和职业中毒,其诊断并不困难,但如治疗方法不当,可出现严重不良后果,甚至死亡。我院自2007年应用高压氧早期治疗一氧化碳中毒212例,取得了较好的效果,报道如下。1资料与方法1.1一般资料212例一氧化碳中毒患者,男147例,女65例;年龄2~65岁,平均31岁。中毒后至首次高压氧治疗的时间均为1~2h。开始进行高压氧     

一氧化碳中毒的颅脑CT表现及临床意义

一氧化碳中毒是急诊较常见病，尤其是在秋冬季节更多，及时准确地诊断、评估中毒程度对治疗方法的选择和预后的判断有重要意义。作者总结了我院1992年至2007年救治的一氧化碳中毒患者38例的诊疗情况，报道如下。     

薄层色谱扫描法和气相色谱/质谱法快速诊断有机磷农药中毒

目的建立薄层色谱法快速定性和气相色谱(GC)/质谱(MS)法定性定量检测有机磷农药,快速诊断有机磷农药中毒。方法检材经二氯甲烷萃取后,薄层色谱法快速定性,GC/MS选择离子模式定性定量检测检材中有机磷农药浓度。结果对硫磷、甲拌磷、马拉硫磷、辛硫磷和久效磷在紫外灯下均有较好的紫外吸收,用双波长薄层色谱扫描仪对斑点做原位紫外吸收扫描,最大吸收波长分别为300,240,225,290,260nm,可配合比移值进行定性分析;GC/MS选择离子检测方式进行定性定量检测,各药物的特征离子峰分别为:97,109,291;76,97,121;93,125,173;77,97,129;67,97,127。结论薄层色谱扫描法定性检测检材中有机磷农药,具有快速、准确、操作简便等特点,加上GC/MS定性定量检测,不仅提高了方法的灵敏度,而且使结果更加准确可靠,可应用于有机磷农药中毒的快速诊断和有机磷农药中毒致死的法医学鉴定。     

有机磷农药中毒51例的抢救体会

<正>有机磷为农业上常用的杀虫剂,在急诊工作中常有急性有机磷中毒者,白城市医院近年共抢救51例中毒患者,取得点滴体会,现报道如下。1资料与方法     

58例小儿急性中毒的临床分析

目的对58例小儿急性中毒病例进行总结,分析急性中毒的相关因素及诊断和治疗。方法对58例急性中毒患儿按中毒发生的原因、毒物种类等不同情况进行分析讨论。结果该组病例中药物中毒居第1位,其次为农药和一氧化碳中毒。小儿急性中毒多发生在婴幼儿至学龄前期,是儿科急诊的常见病之一。婴幼儿时期常为误服药物中毒,而学龄前期主要为有毒物质中毒。结论中毒的预防和急救是儿科急诊抢救的关键。     

一氧化碳中毒并发急性心肌缺血35例临床分析

目的分析总结一氧化碳中毒并发急性心肌缺血病例35例,对其发生原因和防治做出讨论,对其诊断和治疗提供临床支持。方法分析总结一氧化碳中毒并发急性心肌缺血病例35例,对其发生原因和防治做出讨论,对其诊断和治疗提出积极的临床支持。结果急性期积极救治急性心肌缺血,心脏病情稳定后持续行高压氧舱治疗,对改善心肌缺血及一氧化碳中毒所致其他并发症有积极作用。结论提高生活质量,注意防范一氧化碳中毒,平素对冠心病,高血压,糖尿病等疾病的积极治疗,可减少心脏事件发生。     

急诊高压氧救治重度一氧化碳中毒的护理

高压氧对急性一氧化碳中毒有特殊的疗效,它能有效地提高患者的血氧张力,增加血氧含量,提高血氧弥散度和有效弥散距离,有利于改善和纠正一氧化碳中毒后的组织缺氧,也能有效地提高脑组织和脑脊液的氧分压,有利于改善脑功能、降低颅内压,减轻脑水肿。在高压氧舱内各项救治措施的实施,并发症的观察和预防均由护士独立完成。我院急诊科和高压氧科联合救治重度急性一氧化碳中毒患者52例。经一次急诊高压氧治疗后48例,其神志由深昏迷转为清醒,显效率为92.3％,无1例在高压氧舱内发生意外。进舱前的快速准备,进舱后的密切观察,熟练操作和精心护理才能使患者转危为安,现将我们的护理体会报告如下:     

重症海洛因中毒抢救中纳洛酮临床应用分析

目的探讨纳洛酮在重症海洛因中毒抢救中的临床应用。方法回顾性分析19例重症海洛因中毒患者的临床资料和治疗方法,在积极对症治疗的基础上,以纳洛酮为主要抢救药物。结果本组患者19例经过治疗后痊愈18例(占94.7%),死亡1例(占5.3%)。结论对于重症海洛因中毒患者应快速正确的诊断,及时应用纳洛酮及建立人工气道,机械辅助通气,挽救患者的生命;在阿片类毒品中毒的临床抢救中,纳洛酮是最理想、最安全的药物,临床上可普遍应用。     

石家庄地区急性中毒5000例流行病学分析

目的了解石家庄地区急性中毒流行病学特点。方法采用气相色谱法对5209例血液、尿液、呕吐物标本进行检测。结果检出毒物阳性标本5000例,阳性率为96.0%;毒物种类以农药为主（48.3%）,其次为药物（27.1%）、乙醇（8.5%）、鼠药（5.5%）、一氧化碳（4.0%）。男女比例为1∶2.1。急性中毒患者中20～岁占42.6%,40～岁占31.8%。有意中毒占91.2%,中毒途径以消化道为主（86.4%）。结论毒物检测可及时明确中毒病因,为临床诊断和及时救治急性中毒提供依据。     

Fatal poisonings in the Aegean region of Turkey

Between January 1996 and November 2000, 4,251 autopsies were performed at the Council of Forensic Medicine, Morgue Specialization Office, Izmir, Turkey. Among these medicolegal autopsies, 331 fatal poisoning cases (206 men and 125 women) were evaluated retrospectively for their legal investigation results, autopsy findings, and reports of toxicological analyses. The most common cause of fatal poisoning was insecticides (43%). Then followed carbon monoxide (27%) and alcohol (20%). Among the insecticides, the organophosphorus insecticides comprised 78%; all insecticide poisoning cases were suicidal oral ingestions. In fatal alcohol poisoning cases the cause of death was ethanol, methanol and both with 34, 15 and 51% respectively. Drug related deaths were rare.     

A case of carbon monoxide poisoning with thrombus in the heart: a case report

Carbon monoxide is a nonirritant, odorless, colorless gas, and is lighter than air. It is an end product of the incomplete combustion of hydrocarbons. Its effects are most prominent in organs sensitive to oxygen deprivation, such as the heart, brain, and kidney. Carbon monoxide poisoning becomes more abundant in winter and at cold places. In Turkey, every year we see several deaths due to poisonous gas leaks from coal or wood stoves. Deaths particularly due to hypoxia-related central nervous system damage and ventricular dysrhythmias are observed. On the other hand, an association between thromboembolic accidents and carbon monoxide poisoning has been shown in literature. Thromboembolic accidents in the mesenteric, central nervous system, and extremities are reported. However, no atrial thrombus has been mentioned. In this study, a case of an atrial thrombus associated with carbon monoxide poisoning following a diagnosis of carbon monoxide poisoning and treatment in the emergency room is reported and the literature is revisited.     

Epidemiology of acute carbon monoxide poisoning in a Spanish region

BACKGROUND: In Spain, as in most of the world, the incidence of acute carbon monoxide poisoning is probably underestimated. METHODS: During an eighteen-month period we studied, by means of a standardized data collection form, all the cases of acute carbon monoxide poisoning that were diagnosed in 2 university hospitals. RESULTS: During the study, 154 patients were diagnosed with carbon monoxide poisoning. The mean age was 32.2+/-15.5 years. The two principal exposure sites were the kitchen (43%) and bathroom (23%). The majority of the cases related to malfunction of the water heater (30%) and of the central heating (23%) and 68% occurred in the home. Improper combustion of butane (31%), propane (13%), and natural gas (12%) were most frequent. The most prevalent clinical manifestations were headache (94%), dizziness (56%), nausea (45%), loss of consciousness (38%), and weakness (34%). Five patients died. In 14.4%, symptoms suggested delayed neurological syndrome. The largest number of cases of poisoning occurred during the months of December and January. CONCLUSIONS: Compared with previous Spanish series or with the antecedent year, acute carbon monoxide poisoning has a high prevalence in our region. Two factors appear to be essential to the accurate diagnosis of acute carbon monoxide poisoning: 1) the ability of emergency room physicians to recognize the clinical symptoms of carbon monoxide poisoning and 2) access to a carbon monoxide-oximeter.     

A Case of Carbon Monoxide Poisoning with Thrombus in the Heart: A Case Report

Carbon monoxide is a nonirritant, odorless, colorless gas, and is lighter than air. It is an end product of the incomplete combustion of hydrocarbons. Its effects are most prominent in organs sensitive to oxygen deprivation, such as the heart, brain, and kidney. Carbon monoxide poisoning becomes more abundant in winter and at cold places. In Turkey, every year we see several deaths due to poisonous gas leaks from coal or wood stoves. Deaths particularly due to hypoxia-related central nervous system damage and ventricular dysrhythmias are observed. On the other hand, an association between thromboembolic accidents and carbon monoxide poisoning has been shown in literature. Thromboembolic accidents in the mesenteric, central nervous system, and extremities are reported. However, no atrial thrombus has been mentioned. In this study, a case of an atrial thrombus associated with carbon monoxide poisoning following a diagnosis of carbon monoxide poisoning and treatment in the emergency room is reported and the literature is revisited.     

急性CO中毒死亡患者临床特征分析

目的 了解东莞地区急性一氧化碳(CO)中毒死亡患者的临床特征,探讨急性CO中毒的防治策略.方法 对1998年1月-2010年12月期间急诊科接诊和收治的急性CO中毒死亡患者进行系统的回顾性分析研究.结果 13年间共接诊和收治急性CO中毒死亡患者47例,男女比例为1∶1.94;平均年龄(26.76±10.41)岁,高发年...     

急性一氧化碳中毒后发生急性肺损伤的相关危险因素分析

目的 探讨急性一氧化碳中毒后发生急性肺损伤的相关危险因素.方法 整理2007年1月至2009年12月于哈尔滨市第一医院就诊,诊断为“急性一氧化碳中毒”患者180例的临床资料,分为发生急性肺损伤组和未发生急性肺损伤组,收集了指标:年龄、性别、中毒媒介、有无误吸、中毒程度、入院时动脉血氧分压、动脉血乳酸;入院时血常规白细胞计数;入院时生化肌酸激酶浓度.进行了单因素分析、Logistic回归分析,筛选出急性一氧化碳中毒后发生急性肺损伤的相关危险因素.结果 该研究总例数180例,男86例,女94例,年龄(42.90±18.99)岁.发生急性肺损伤患者38例,患病率21.11％.通过单因素分析显示年龄、性别、入院时血氧分压发生急性肺损伤组和未发生急性肺损伤组比较差异无统计学意义(P＞0.05).有无误吸;中毒媒介;中毒程度;昏迷时间;入院时动脉血乳酸、入院时血常规白细胞计数、入院时生化肌酸激酶浓度,两组比较差异有统计学意义(P＜0.05).对单因素分析差异有统计学意义的指标进行二项logistic回归分析,显示误吸、重度中毒、煤烟中毒、血动脉乳酸升高的OR值分别为3.06、4.80、2.00、1.20;均是急性一氧化碳中毒后发生急性急性肺损伤的相关危险因素(P＜0.05).结论 误吸、重度中毒、煤烟中毒、血乳酸升高均是急性一氧化碳中毒后发生急性急性肺损伤的危险因素.     

Elevated Carboxyhaemoglobin Concentrations by Pulse CO‐Oximetry is Associated with Severe Aluminium Phosphide Poisoning

In pulse CO‐oximetry of aluminium phosphide (ALP)‐poisoned patients, we discovered that carboxyhaemoglobin (CO‐Hb) level was elevated. We aimed to determine whether a higher CO level was detected in patients with severe ALP poisoning and if this could be used as a prognostic factor in these patients. In a prospective case – control study, 96 suspected cases of ALP poisoning were evaluated. In the ALP‐poisoned group, demographic characteristics, gastric and exhalation silver nitrate test results, average CO‐Hb saturation, methaemoglobin saturation, and blood pressure and blood gas analysis until death/discharge were recorded. Severely poisoned patients were defined as those with systolic blood pressure ≤80 mmHg, pH ≤7.2, or HCO₃ ≤15 meq/L or those who died, while patients with minor poisoning were those without any of these signs/symptoms. A control group (37 patients) was taken from other medically ill patients to detect probable effects of hypotension and metabolic acidosis on CO‐Hb and methaemoglobin saturations. Of 96 patients, 27 died and 37 fulfilled the criteria for severe poisoning. All patients with carbon monoxide saturation >18% met the criteria to be included in the severe poisoning group and all with a SpCO >25% died. Concerning all significant variables in univariate analysis of severe ALP toxicity, the only significant variable which could independently predict death was carbon monoxide saturation. Due to high mortality rate and need for intensive care support, early prediction of outcome is vital for choosing an appropriate setting (ICU or ordinary ward). CO‐oximetry is a good diagnostic and prognostic factor in patients with ALP poisoning even before any clinical evidence of toxicity will develop.     

综合治疗一氧化碳中毒后并发迟发性脑病临床分析

目的探讨一氧化碳中毒后并发迟发性脑病的临床特点及综合治疗的疗效。方法回顾性总结47例一氧化碳中毒后并发迟发性脑病,分析其特点,并给予高压氧、激素及药物综合治疗。结果痊愈21例（占26.3%）,总有效40例（占85.1%）。结论一氧化碳中毒迟发性脑病如能及时诊断、积极治疗,预后较好。     

丁苯酞治疗一氧化碳迟发性脑病荟萃分析

目的:系统性评价丁苯酞治疗一氧化碳中毒性脑病的疗效.方法:在万方数据-数字化期刊群、中国期刊全文数据库(中国知网)、维普科技期刊数据库、PubMed、EMBase、ClinicalKey数据库中,检索2009年1月至2020年8月的相关研究,探索丁苯酞预防及治疗一氧化碳迟发性脑病的疗效.采用RevMan 5.3软件对各...