摘要:目的:探讨Ⅰ型肾小管酸中毒( RTA) 患者的临床特征及误诊分析。方法: 回顾性分析我院51例Ⅰ型RTA患者的临床资料, 包括临床表现、实验室检查、诊断及误诊情况、并发症及治疗转归等。结果:Ⅰ型RTA 临床表现多样,复杂,无特异性,外院误( 漏)诊率高达64.7%,易并发或伴发多种疾病。 结论: 临床上应提高对Ⅰ型RTA的认识, 做出早期诊断和治疗。Abstract: Objective: To investigate the clinical features and misdiagnosis of distal renal tubular acidosis(RTA), or type 1 RTA. Methods: Data of 51 cases with type 1 RTA were analyzed retrospectively,including clinical features, laboratory examinations,diagnostic errors, complications and therapeutics. Results: The clinical features of type 1 RTA were complicated and were easy to be misdiagnoed.The misdiagnosis rate were as high as 64.7% in other hospitals.Conclusion: Type 1 RTA should be further recognized in clinic in order to make earlier diagnose and treatment.
目的:观察百草枯中毒大鼠血浆和肺组织匀浆中的内皮素-1的动态变化,探讨大鼠PQ中毒肺损伤的可能机制。方法:将雄性Wistar大鼠随机分成百草枯中毒组和生理盐水对照组,分别给予16mg/kg百草枯或等体积生理盐水腹腔内注射,并在给药后6、12、24和72 h处死大鼠,观察其一般表现、肺的病理变化。测定肺系数、肺组织匀浆和血浆中内皮素-1的含量。结果: 百草枯中毒后大鼠出现呼吸困难,活动能力下降,肺系数增加,并随时间变化,光镜下表现为肺出血、水肿等不同程度的肺损伤改变。血浆和组织匀浆中内皮素-1在中毒后与对照组大鼠比较明显升高,并随时间变化(Plt;0.01)。结论:在百草枯中毒肺损伤中,内皮素-1可能发挥了重要作用。
目的：探讨毒蕈中毒所致中毒性肝炎的临床表现、治疗与预后关系。方法：对3例急性毒蕈中毒患者进行回顾性临床分析。结果：3例患者均出现中毒性肝炎，2例经治疗后好转，1例因多器官功能衰竭死亡。结论：中毒性肝炎如导致多脏器损害，预后差；及早洗胃，彻底清除毒物是救治关键；血浆置换治疗有一定疗效，肝移植是最有效的治疗手段。
摘要:目的:探讨有机磷农药中毒患者阿托品使用方法,提高抢救成功率。方法: 对2005年6月至2009年6月我院收治的有机磷农药中毒病人281例进行分组,所有患者均使用阿托品疗法,A组为2007年以后132例序贯阿托品疗法患者,B组2007年以前为常规使用静推继之肌注阿托品疗法149例患者,根据有机磷农药对胆碱酯酶复能剂的疗效分为高效组和低效组,并结合病情严重程度共分为重度有机磷农药中毒胆碱酯酶复能剂高效组、重度有机磷农药中毒胆碱酯酶复能剂低效组,轻度有机磷农药中毒胆碱酯酶复能剂高效组、轻度有机磷农药中毒胆碱酯酶复能剂低效组4组,分别从达到阿托品化时间、维持阿托品化效果、反跳和中间综合征发生率、开始撤药平均时间、总住院费用、总住院平均时间、护士劳动强度进行总结和分析。结果: 维持阿托品化疗效Ａ组与B组间有显著差异,P值lt;0.01,开始撤药平均时间、总住院平均时间、总住院费用、护士劳动强度Ａ组与B组间均有差异,P值lt;0.05,发生反跳和中间综合征发生率、达到阿托品化时间在高效组间比较无差异,低效组间比较无差异,高效组与低效组比较有显著差异,P值lt;0.01,主要与中毒药物种类和病情严重程度有关,其次与阿托品治疗方法有关。 结论: 序贯阿托品疗法治疗有机磷农药中毒优于常规使用静推继之肌注阿托品疗法。Abstract: Objective: To discussion of atropine in organophosphorus pesticide poisoning patients with the use of two different methods to improve the success rate. Methods: For June 2005 to June 2009 inour hospital a total of organophosphorus pesticide poisoning 281 cases were divided into A group and B group, All patients were using atropine therapy, 132 cases of sequential therapy in patients with atropine is divided into A group, 149 cases of routine use of intravenous injection and intramuscular injection of atropine group patients were divided into B group, From the following aspects were analyzed and summarized, They are the maintenance of the effect of atropinization, the average time for the beginning of withdrawal, the total hospitalization costs, the total average time for hospitalization and nurses labor intensity. According to the organic phosphorus pesticide on the efficacy of cholinesterase agents are divided into efficient and inefficient groups groups, From the types of poisons, toxic ways, poisoning performance and Complications for stratified, They were divided into 4 groups, severe organophosphorus pesticide poisoning and cholinesterase reactivator can be highly effective group, severe organophosphorus pesticide poisoning and cholinesterase reactivator Lowefficacy group, mild organophosphorus pesticide poisoning and cholinesterase reactivator can be highly effective group, mild organophosphorus pesticide poisoning and cholinesterase reactivator Lowefficacy group, Correlation analysis Antijumping and the incidence of intermediate syndrome and atropinization time.Results:Maintain the efficacy of atropine of A group and B were significantly different between groups, Plt;0.01, the average time began to withdraw drugs, the total average time for hospitalization, total hospital charges, nursing labor intensity of A group and B are differences between the two groups, P＜0.05. Rebound occurs and the incidence of intermediate syndrome, to atropinization time high between the two groups showed no difference between the two groups showed no differences between inefficient and efficient group and inefficient group were significantly different, Plt;0.01, mainly related to poisoning by drug type and severity of illness, followed with atropine therapy. Conclusion:Atropine sequential therapy is superior to organophosphorus pesticide poisoning by conventional atropine treatmen.
Objective To evaluate the effectiveness of Xingnaojing (XNJ) injection in the treatment of acute alcohol intoxication. Methods The Cochrane library (Issue 4, 2008), MEDLINE (1989 to 2008), WANFANG database (1991 to 2008), CBM (1991 to 2008), and CNKI (1991 to 2008) were searched. The quality of included studies was assessed according to the criteria recommended Cochrane Collaboration.Meta-analyses were performed using RevMan 4.2.2 software. Results Twenty seven trials, all published in China were included. The quality of these studies was low. Meta-analyses showed that normal treatment plus XNJ could significantly shorten action time [WMD= – 90.62 min, 95%CI (– 121.12, – 60.11)] and effective time [WMD= – 124.97 min, 95%CI (– 183.54, – 66.40)]. Normal treatment plus XNJ was similar with normal treatment plus naloxone in action time. No significant differences were observed in effective time between naloxone and XNJ. Conclusions It shows that XNJ injection plus western medical therapy is superior to western medical therapy. The curative efficacy of XNJ and Naloxone was similar.
目的 探讨H2受体拮抗剂和质子泵抑制剂（PPI）缓解急性胃黏膜损伤的时效性研究。 方法 对2008年1月－2010年1月在急诊科就诊的98例急性乙醇中毒后胃黏膜损伤患者，随机分为对照组50例，治疗组48例。常规给予休息、保暖，补液，维持水、电解质、酸碱平衡，维持循环功能等治疗基础上，对照组给予H2受体拮抗剂治疗，治疗组给予PPI治疗。通过观察急性胃黏膜损伤患者上消化道症状及体征，记录不同饮酒及饮酒量，并根据患者就诊时间及不同饮酒组治疗后上消化道症状完全缓解时间进行比较。 结果 治疗组上消化道症状缓解所需时间与对照组比较差异有统计学意义（P＜0.001），不同饮酒组上消化道症状缓解时间上差异有统计学意义（P=0.000）。 结论 PPI在缓解急性乙醇中毒所致胃黏膜损伤的时效上更明显，具有临床价值。