重度氨中毒伴心肌损伤1例报告

A Case Report of Severe Ammonia Poisoning with Myocardial Damage

患者男性,26岁,因液氨钢瓶爆裂,吸入氨气中毒昏迷。胸部X线片示:两肺见散在片状模糊阴影;心酶谱检查结果显示:乳酸脱氢酶1193U/L、肌酸激酶1408U/L,肌酸激酶同工酶CK-MB 62U/L,提示出现中毒性心肌损伤。经对症处理、维持气道通畅、纤维支气管镜肺灌洗等治疗后,患者痊愈出院,经随访无后遗症。提示,应当及早预防氨中毒,一旦发生氨中毒,则应及时予以检查,对症救治,谨防心肌损伤。

A male worker, 26 years old, was reported coma with ammonia inhalation due to explosion of a liquid ammonia steel canister. The chest X-ray images revealed scattered patchy shadows in both lungs. The significantly higher levels of lactate dehydrogenase （1 193 U/L）, creatine kinase （1408 U/L）, and creatine kinase isoenzyme CK-MB （62 U/L） indicated toxic myocardial damage. After treated with mechanical ventilation and lung lavage by hronchoscopy, the patient was recovered and discharged. No further symptom or sign was found in the follow-up visit. It is imperative that employers and employees should take appropriate measures to prevent ammonia intoxication in good time and receive promptly treatment to prevent myocardial damage.