儿童急性盐酸克仑特罗中毒临床特征分析及救治

Clinical features and treatment of acute clenbuterol poisoning in children

目的分析儿童急性盐酸克仑特罗中毒的临床特点、救治方法与效果,为临床及时认识和早期诊治提供依据。方法对2011年4月住院的28例急性盐酸克仑特罗中毒患儿的临床资料进行回顾性分析。结果 28例患儿中,男15例,女13例,年龄1至13岁(平均年龄7±5岁)。中毒后主要表现为呕吐、心悸、肢体抖动等;血生化改变主要为低血钾、高乳酸血症、高血糖、血肌酸激酶增高等,心电图改变主要为窦性心动过速和S-T段下移。经使用β受体阻滞剂及补钾、护心等处理后,患儿在12～78 h后症状逐渐缓解。入院后48 h后血生化指标得到明显改善,5 d后全部痊愈出院。随访半个月无复发。结论儿童急性盐酸克仑特罗中毒以呕吐、心悸、肢体抖动、低血钾、高乳酸血症、心动过速为主要特征。早期积极采取有效的抢救措施可提高救治成功率。

Objective To study clinical features, treatment and curative effects in children with acute clenbuterol poisoning, in order to provide a basis for early diagnosis and treatment. Methods Clinical data of 28 hospitalized children with acute clenbuterol poisoning in April 2011 were retrospectively studied. Results Of the 28 patients, there were 15 males and 13 females, aged 1 to 13 years （mean age 6.5 ± 4.8 years）. Vomiting, palpitations and limb shaking were found as main clinical manifestations in the patients. Main changes of blood biochemical included hypokalemia, lactic acidosis, hyperglycemia, hypsocreatinkinase. Snus tachycardia and S-T segment depression were observed on ECG. Patients＇ symptoms were gradually alleviated after 12-78 hours by use of beta blockers, potassium supplement, protecting the heart and other symptomatic and supportive treatment. Blood biochemical indexes were improved after 48 hours of admission. All of the patients were cured after 5 days. The symptoms of the patients do not longer occur during a follow up of half a month. Conclusions Acute clenbuterol poisoning is characterized by vomiting, palpitations, limb shaking, hypokalemia, lactic acidosis and tachycardia in children. An early effective treatment of this disease can improve prognosis in children.