乌头碱中毒132例诊治分析

Diagnosis and Treatment of Aconitine Poisoning:A Report of 132 Cases

目的：探讨乌头碱中毒的临床特征，总结诊断和治疗经验以提高抢救成功率。方法：对我院1988年1月至2007年12月132例乌头碱中毒患者资料进行回顾性分析。结果：发生心律失常127例，占96.21%。其中发生室性早搏71例，占53.79%；47例呈频发多源性室早二联律或三联律；室性心动过速27例，占20.45%，心率140-230 min^-1，其中12例为多源性室性心动过速；窦性心动过缓、房室传导阻滞39例，占29.55%；心房纤颤4例，占2.27%。中毒性休克17例，占12.88%。结论：乌头碱中毒突出表现为不同形式的心律失常，对严重室性心律失常者，迅速应用足量利多卡因、大剂量糖皮质激素、含镁极化液是抢救成功的关键。

Objective： To explore the clinical manifestations of aeonitine poisoning, and to summarize its diagnostic and treatment experiences. Methods ：132 cases were retrospectively studied at our hospital from Jan. 1988 to Dec. 2007. Results ：127 cardiac arrhythmias （96. 21% ） were found, from which, 71 cases were ventricle premature beat （53.79%）and 47 cases were recurrent multiple ventricular bigeminy or trigeminy; 27 cases were ventricle tachycardia （20. 45% ） with heart rate of 140 - 230 min^-1, from which 12 cases were multiple ventricle tachycardia. 39 cases （29.55%） were sinus bradycardia and atrioventricular block, 4 were atrial fibrillation （2.27%）. 17 were toxic shock （12.88%）. Conclusion： The clinical manifestations of aconitine poisoning are different forms of cardiac arrhythmias. Rapid application of sufficient Lidocaine, large dose of glucocorticoid and Magnesium Polarization Liquid is the key to successful rescue for severe ventricle cardiac arrhythmias.