急性鱼胆中毒36例诊治体会

DIAGNOSIS AND TREATMENT OF 36 CASES OF ACUTE FISH BILE POISONING

目的：报道误食鱼胆所致急性中毒的临床表现及诊治方法。方法：对３６ 例急性鱼胆中毒的原因，致病物质的毒性，患者的临床表现、化验检查及治疗方法等进行探讨。结果：中毒的轻重与进食鱼胆的数量治疗的早晚有关，临床表现首发为恶心、呕吐、头昏等，继而出现少尿，黄疸、肝、肾功能异常，部分病例发生脑症状、消化道出血和（ 或） 急性溶血性贫血。治疗应及时洗胃、导泻与服活性碳等，对严重肝、肾损害者，尽早血液透析和辅以激素治疗。结论：因中毒者均有明显食鱼胆史，故易诊断，临床上除及时按消化道中毒常规处理外，应尽早血液透析，这是对严重的内源性或外源性中毒的有效措施。

OBJECTIVE:To investigate the clinical manifestation and management of acute fish bile poisoning by mistaken eating fish gallbladder.METHOD:Data including reasons of poisoning,clinical manifestation,lab tests and treatment were analysed.RESULTS:Degree of poisoning was associated with quantity of mistaken bile and time of being treated.Patients presented nausea,vomiting,dizziness,followed by oliguria,jaundice and abnormal function ofliver and kidney.Part of the cases presented brain symptom,digestive tract bleeding and/or acute hemolytic anemia.Immediate gastric lavage,catharsis and use of activated carbon wree important. For patients with liver and kidney impairment,early dialysis and steroid therapy were suggested.CONCLUSION:Ensured history of mistaking of fish gallbladder can help the diagnosis.In addition to regular management of digestive tract,early dialysis is effective to endogenous or extrnsic poisoning.