鱼胆中毒致脏器损伤37例临床分析

发布时间：2018-05-23 21:41

本文选题：鱼胆中毒 + 多器官功能障碍综合征　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:通过分析37例口服鱼胆中毒患者的临床资料,研究鱼胆中毒致脏器损伤临床特征,探讨有效的治疗方法,指导临床治疗、评估预后。方法:收集2010年1月~2016年12月期间于吉林大学第一医院住院的口服鱼胆中毒患者的完整临床资料,对患者的一般资料、临床表现、化验检查指标、治疗方式、方法及转归进行回顾性分析。结果:1、37例鱼胆中毒患者经治疗后全部好转出院,治愈率100%。2、进食鱼胆后症状最早发生于0.5小时,最晚发生在第10天。入院时主诉以“胃肠道症状”为主要表现者30例,以“无尿”或“少尿”为主诉者6例;以“发热”为主要表现者1例。3、所有患者均有不同程度的肝功、肾功、心肌酶异常,且治疗前后对比均有显著性差异(P0.05)。4、器官损伤个数1~4个,2个脏器损伤者为数最多。部分患者出现浆膜腔积液(6例)、电解质紊乱(14例)、尿路感染(4例)、高血压(8例)、精神症状(10例),并有2例患者出现ARDS。5、30例给予血液净化治疗;7例拒绝血液净化治疗。HD、CRRT、CRRT后继续规律HD以及CRRT直接联合HP四种血液净化方式相比较,其住院时间逐渐缩短。结论:1、鱼胆中毒后脏器损伤数目与进食鱼胆数目不相关;2、鱼胆中毒后多以胃肠道症状为首发表现,其后出现不同程度肝、肾、心、脑等器官损伤;3、鱼胆中毒后及时就医并经积极保护脏器及对症治疗以及配合血液净化治疗后疗效显著;4、CRRT联合HP血流动力学稳定,并发症少,有助于脏器功能恢复,缩短住院时间;5、是否合并基础疾病、年龄、器官损伤数目及血液净化方式均可影响鱼胆中毒患者预后,可作为评估鱼胆中毒预后的参考指标。
[Abstract]:Objective: to analyze the clinical data of 37 patients with fish bile poisoning, to study the clinical characteristics of visceral injury caused by fish bile poisoning, to explore the effective treatment method, to guide the clinical treatment and to evaluate the prognosis. Methods: from January 2010 to December 2016, we collected the complete clinical data of patients with oral fish gallbladder poisoning hospitalized in the first Hospital of Jilin University, and analyzed the general data, clinical manifestations, laboratory examination indexes and treatment methods of the patients. Methods and outcome were analyzed retrospectively. Results all 37 cases of fish bile poisoning were cured and discharged after treatment, the cure rate was 100. 2. The symptoms after eating fish bile occurred first at 0.5 hours, and the last occurred on the 10th day. At admission, the main complaints were "gastrointestinal symptoms" in 30 cases, "anuria" or "oliguria" in 6 cases, and "fever" in 1 case (.3). All the patients had different degrees of liver function, renal function and myocardial enzyme abnormality. There were significant differences before and after treatment (P 0.05. 4), the number of organ injury was 1 ~ 4, the number of two organ injuries was the most. There were 6 cases of serous cavity effusion, 14 cases of electrolyte disorder, 4 cases of urinary tract infection, 8 cases of hypertension, 10 cases of mental symptoms, and 2 cases of ARDS.530 cases. 7 cases refused blood purification treatment. Comparing the four ways of blood purification, HD and CRRT combined directly with HP after CRRT, The length of hospitalization was gradually shortened. Conclusion the number of organ injury after fish bile poisoning is not correlated with the number of fish bile intake. Gastrointestinal symptoms are the first manifestation of fish bile poisoning, and liver, kidney and heart appear in different degrees after fish bile poisoning. Brain and other organs were injured. After fish bile poisoning, the patients were treated with active organ protection, symptomatic treatment and blood purification therapy. The curative effect of CRRT combined with HP was stable, and the complications were less, which was helpful to the recovery of organ function. The prognosis of the patients with fish bile poisoning can be evaluated by shortening the hospitalization time or not, whether they are complicated with basic diseases, age, the number of organ damage and the blood purification mode, which can be used as a reference index to evaluate the prognosis of fish bile poisoning.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R595.7

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