河豚鱼中毒的抢救

Experience on rescue of tetrodontoxism

目的总结河豚鱼重度中毒的抢救技术。方法综合治疗基础上,针对河豚鱼重度中毒出现昏迷、四肢瘫痪、呼吸肌麻痹的情况,给予机械通气,当观察到患者呼吸表浅而经皮血氧饱和度开始下降而未见明显下降时,即及早采用喉罩,建立有效的人工气道进行机械通气。结果本组11例中毒患者,4例重度中毒,3例应用机械通气,全部治愈出院。结论及时、正确机械通气是抢救重度河豚鱼中毒最有效的方法。这为河毒素在人体内解毒和排泄争取时间,并可能阻断病情的恶性循环,避免病情进一步加重。另外,采用喉罩,能选择适当时机、迅速建立人工气道,减低氧耗,减少并发症。

Objective To summarize the technique of rescuing heavy tetrodontoxism.Methods Basing on comprehensive treatment,the patients,who shew coma,quadriplegia or respiratory muscle paralysis because of heavy tetrodontoxism,received mechanical ventilation.When the patients' blood oxygen saturation beginning to go down,not obviously down with weak breathe,they received effectively mechanical ventilation with artificial airway by laryngeal mask as soon as possible.Results The 11 patients,including 4 heavy tetrodontoxism and 3 cases that received mechanical ventilation were all cured and out of hospital.Conclusions Mechanical ventilating in time and correctly is the most effective method to resuce heavy tetrodontoxism by which the tetrodotoxin could have enought time to be broken down and to be get rid of in case,so as to avoid the case deterioration.On the other hand,the laryngeal mask are used properly to establish artificial airway to wasting less time than endotracheal intubating,which often lead serious hypoxaemia for spending more time,and it can also reduce oxygen consumption and complications.