生鱼胆中毒24例的临床特点与救治

Clinical features and management of raw fish gallbladder poisoning in 24 patients

目的:调查生鱼胆中毒患者的临床特点。方法:收集2004年5月至2008年10月期间生鱼胆中毒住院患者的临床资料,分析患者的性别、年龄、服用生鱼胆的个数、中毒发生时间与症状、肝肾功能、心肌酶水平、治疗及转归。结果:共24例生鱼胆中毒患者,其中男性9例,女性15例,年龄8～65岁,平均年龄(26.9±3.4)岁。每人服用生鱼胆1～2个。服后2～72h,出现急性胃肠反应,其中15例伴急性肾衰竭[BUN(34.5±13.7)mmol/L,SCr(825±172)μmol/L],12例伴肝功能不全[ALT(958±523.5)U/L,AST(562.5±256.8)U/L],12例伴心肌损害[LDH(3423.4±101.5)U/L]。经血液灌注和血液透析治疗后患者恢复正常。结论:生鱼胆可致多脏器衰竭。血液灌注和血液透析联用是治疗生鱼胆中毒的有效措施。

Objective： To investigate the clinical features of raw fish gallbladder poisoning. Methods： Between May 2004 and October 2008, clinical data of in-patients with raw fish gallbladder poisoning were collected. The patients＇ sex and age, number of raw fish gallbladder ingestion, onset time and symptoms of intoxication, liver and renal function, myocardial enzyme levels, management, and outcome were analysed. Results： A total of 24 cases of raw fish gallbladder poisoning comprised 9 men and 15 women aged 8-65 years [ average age （26.9 ± 3.4） years J. Every patient took 1-2 raw fish gallbladder. Acute gastrointestinal disorders occurred 2-72 hours after taking raw fish gallbladder. Of them, 15 patients were accompanied with renal failure [ BUN （34.5 ± 13.7） mmol/L, SCr （825 ± 172） μmol/L], 12 were accompanied with liver function insufficiency [ALT （958 ±523.5） U/L, AST （562.5 ±256.8） U/L], and 12 were accompanied with heart damage [LDH （3 423.4 ± 101.5） U/L]. After blood perfusion and hemodialysis, the patients recovered. Conclusion： Raw fish gallbladder may cause muhiorgan failure. Blood perfusion combined with hemodialysis is an effective measure for management of raw fish gallbladder poisoning.