急性三烷基锡中毒107例诊治分析

Acute trialkyl-tin intoxication:report of 107 cases

目的探讨急性三烷基锡中毒的临床特征、诊断和治疗措施。方法对1999～2006年107例急性三烷基锡中毒患者的临床资料进行回顾性分析。结果急性三烷基锡中毒以中枢神经系统损害为主的全身性疾病,多伴有低血钾和高血氨。重度中毒患者还存在顽固性酸中毒和中枢脱髓鞘改变。结论急性三烷基锡中毒缺乏特异性诊断方法,结合毒物接触史、神经系统损害表现以及实验室检查对诊断有重要的意义。早期综合性治疗是抢救成功的关键。

Objective To describe the clinical characteristics,diagnosis and management of acute trialkyl-tin intoxication.Methods We reviewed and analyzed the records of 107 patients admitted to our hospital with the diagnosis of acute trialkyl-tin intoxication from 1999 to 2006.Results Patients with trialkyl-tin intoxication mostly manifested neurological symptoms with hyperammonemia and hypokalemia.Hypokalemia and metabolic acidosis with white matter demyelination were seen in neurological CT or MRI scans of severely poisoned cases.Conclusion No specific methods of diagnosis and treatment of trialkyl-tin poisoning exist.A history of exposure,and neurological symptoms with hyperammonemia and hypokalemia may be useful for early diagnosis.The comprehensive therapy and the early use of steroid may be helpful.A good outcome depends on early diagnosis and treatment.