6例儿童急性鱼胆中毒临床分析

A clinical analysis of 6children with acute fish bile poisoning

目的:分析总结儿童鱼胆中毒的原因、临床特征、救治方法和治疗效果,探讨儿童鱼胆中毒造成多器官功能损害的机制和有效治疗手段。方法:回顾分析6例儿童鱼胆中毒的原因,致病物质的毒性,患者的临床表现、实验室检查资料及治疗方法和治疗效果等。结果:6例(100%)鱼胆中毒患儿出现胃肠道症状,5例(83.3%)出现急性肾功能衰竭,5例(83.3%)出现中毒性肝炎,4例(66.6%)出现心肌受损,4例(66.6%)有神经系统表现。经过血液透析(HD)或持续静脉-静脉血液滤过(CVVH),结合其他综合治疗措施后,5例治愈,1例死亡。结论:儿童鱼胆中毒可导致多器官功能衰竭,尽早血液滤过可提高儿童鱼胆中毒的治疗效果与生存率。

Objective：To analyze the cause,clinical features,treatment and effects of multiple organ fali-ure with fish bile poisoning in children.Method：The reasons of poisoning,the toxicity of pathogenic material,clinical manifestation,laboratory examination and treatment of 6cases of fish bile poisoning in children were analyzed retrospectively.Result：All of the cases were suffered with gastrointestinal symptoms,5cases （83.3%）had acute renal failure,5cases（83.3%）had toxic hepatitis,4cases（66.6%）of direct myocardial loss and4cases（66.6%）had neurological manifestations.5children were cured after hemodialysis（HD）or continuous veno-venous hemofiltration（CVVH）.Only one child died with MOF.Conclusion：Fish gall bladder poisoning can cause multiple organ failure,early hemofiltration may improve the survival rate of gall blad-der poisoning of children.