Hotspots and concerns in diagnosis and treatment of acute poisoning

doi:10.3877/cma.j.issn.2096-1537.2019.02.005

Abstract

Abstract:

Acute intoxication is a common emergency in China with a characteristics of high incidence, many kinds of poisonous species and a huge geography season variation. Most acute poisoning are lack of a standard diagnosis and treatment protocol, which leads difficulty in the treatment of acute poisoning and high mortality and great harm to society. We elaborated the problems in the diagnosis and treatment of common acute poisoning in recent years, such as organophosphorus poisoning, diquat poisoning, mushroom poisoning, methanol poisoning, marine biotoxin poisoning in this review, in order to improve the treatment of acute poisoning in China.

Key words: Acute poisoning, Organophosphorus poisoning, Diquat poisoning, Mushroom poisoning, Methanol poisoning, Tetrodotoxin poisoning

Longwang Chen, Zhongqiu Lu. Hotspots and concerns in diagnosis and treatment of acute poisoning[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(02): 104-108.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2019.02.005

https://icu.cma-cmc.com.cn/EN/Y2019/V05/I02/104

Figures/Tables 1

References 28

1	姚冬奇，田英平. 2013急诊医学回顾与展望:急性中毒 [J]. 中国急救医学, 2014, 34(1):4-17.
2	Krenzelok KP. New developments in the therapy of intoxications [J]. Toxicology Lett, 2002, 127(1-3):299-305.
3	中国医师协会急诊医师分会. 急性有机磷农药中毒诊治临床专家共识(2016) [J]. 中国急救医学, 2016, 36(12):1057-1065.
4	Mackenzie RSJ, Brewin CR, Curran HV, et al. Neuropsychological and psychiatric functioning in sheep farmers exposed to low levels of organophosphate pesticides [J]. Neurotoxicol Teratol, 2010, 32(4):452-459.
5	林旷德，石恒彦，李中原. 有机磷农药中毒救治中阿托品化的观察体会 [J]. 中国全科医学, 2008, 11(4):329.
6	严林. 阿托品化定量评分在治疗急性重度有机磷农药中毒的临床研究 [J]. 现代诊断与治疗, 2015, 26(7):1462-1463.
7	来红，杨伯泉，俞晓明. 血液灌流抢救重度有机磷中毒的疗效观察 [J]. 急诊医学杂志, 2000, 9(1):68.
8	王勇强，史晓峰，张磊, 等. 血液灌流、换血疗法治疗急性中重度有机磷农药中毒效果评价 [J]. 天津医学杂志, 2003, 31(2):92-93.
9	Martinez-Chuecos J, DeI Carmen Jurado M, Paz Gimenez M. Experience with hemoperfusion for organophosphate poisoning [J]. Crit Care Med, 1992, 20(11):1538-1543.
10	刘学，任晓东，张宏军. 灭生性除草剂敌草快与百草枯杀草活性比较 [J]. 农药科学与管理, 2006, 25(9):27-30.
11	赵旭明，朱建军，朱建良, 等. 百草枯"孪生兄弟"敌草快急性中毒的新认识 [J]. 中国急救医, 2018, 38(6):493-496.
12	Manabe J, Ogata T. Lung fibrosis induced by diquat after intratracheal administration [J]. Arch Toxicol, 1987, 60(6):427-431.
13	Eren SH, Demirel Y, Serdal U, et al. Mushroom poisoning: retrospectiveanalysis of 294 cases [J]. Clinics(Sao Paulo), 2010, 65(5):491-496.
14	杨远征，刘琼，徐防. 急性毒蕈中毒临床分析 [J]. 重庆医学, 2008, 37(22):2527-2528.
15	赵从，王永安，王汉斌. 急性毒蕈中毒发病机制与诊治进展 [J]. 中国医刊, 2007, 42(9):35-37.
16	卢中秋. 我国急性中毒救治现状:机遇与挑战并存 [J]. 中华急诊医学杂志, 2016, 25(11):1351-1354.
17	宋佳星，唐亚慧，洪广亮, 等. 急性重度甲醇中毒致多发颅内出血一例[J]. 中华劳动卫生职业病杂志, 2018, 36(3):219-220.
18	Barceloux DG, Bond GR, Krenzelok EP, et al. American Academy of Clinical Toxicology practice guidelineson thetreatment of methanol poisoning [J]. J Toxicol Clin Toxicol, 2002, 40(4):415-446.
19	史晶，江朝强，杨志前, 等. 急性甲醇中毒的神经系统损害——42例临床病例分析 [J]. 中国职业医学, 2009, 36(6):478-479.
20	Roberts DM, Yates C, Megarbane B, et al. recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning: a systematic review and consensus statement [J]. Crit Care Med, 2015, 43(2):461-472.
21	Barceloux DG, Bond GR, Krenzelok EP, et al. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning [J]. J Toxicol Clin Toxicol, 2002, 40(4):415-446.
22	史贤明. 食品安全与卫生学 [M]. 3版. 北京: 中国农业出版社, 2009.
23	Fujii M, Harada K, Mateuda M. Counteraction of the effects of puffer poison by cysteine [J]. Saga Daigaku NOgaku Iho, 1967, 24:1.
24	谢克勤，于丽华，张理, 等. 碳酸氢钠等化合物对小鼠河豚毒素急性中毒的拮抗作用 [J]. 山东大学学报, 2002, 40(3):227-229.
25	中国医师协会急诊医师分会. 急性百草枯中毒诊治专家共识(2013) [J]. 中国急救医学, 2013, 33(6):484-489.
26	急性酒精中毒诊治共识专家组. 急性酒精中毒诊治共识 [J]. 中华急诊医学杂志, 2014, 23(2):135-137.
27	中国医师协会急诊医师分会. 急性中毒诊断与治疗中国专家共识 [J]. 中华急诊医学杂志, 2016, 25(11):1361-1375.
28	Capriotti AL, Caruso G, Cavaliere C, et al. Multiclass mycotoxin analysis in food, environmental and biological matrices with chromatography/mass spectrometry [J]. Mass Spectrom Rev, 2012, 31(4):466-503.

指标	观察结果	分数
皮肤	大汗淋漓或湿润	-2
?	干燥或红润	2
?	皮肤发烫、绯红	3
口干	口腔内分泌物较多	-2
?	口腔内分泌物较少	2
?	舌苔干燥、口唇干裂	3
神志	嗜睡、模糊或昏迷	0
?	清醒	1
?	小躁动、谵妄或再次昏迷	2
体温（℃）	<37	0
?	37~38	1
?	>38	2
瞳孔（mm）	<3.0	0
?	3.0~5.0	1
?	>5.0	2
心率（次/min）	<70	0
?	70~100	1
?	>100	2
肺部啰音	有	0
?	无	1

指标	观察结果	分数
皮肤	大汗淋漓或湿润	-2
?	干燥或红润	2
?	皮肤发烫、绯红	3
口干	口腔内分泌物较多	-2
?	口腔内分泌物较少	2
?	舌苔干燥、口唇干裂	3
神志	嗜睡、模糊或昏迷	0
?	清醒	1
?	小躁动、谵妄或再次昏迷	2
体温（℃）	<37	0
?	37~38	1
?	>38	2
瞳孔（mm）	<3.0	0
?	3.0~5.0	1
?	>5.0	2
心率（次/min）	<70	0
?	70~100	1
?	>100	2
肺部啰音	有	0
?	无	1

[1]	Li Qiu, Ying Deng. Clinical analysis of mushroom poisoning in children [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(02): 199-203.
[2]	Hehe Chen, Yan Wang, Zhuoya Dong, Xinchao Yan, Peisen Ruan, Hua Guan. Clinical analysis and treatment of 3 children with acute diquat poisoning [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(02): 180-184.
[3]	Fei Xu, Ya Jiang, Chao Liu, Yao Wu, Bing Li. Effect of sequential blood purification combined with naloxone on blood gas parameters, hemorheology, and inflammatory factors in patients with acute poisoning [J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(03): 236-240.

Please choose a citation manager

Content to export