肉毒杆菌食物中毒急诊救治一例

Emergency treatment of botulism food poisoning: one case report

肉毒杆菌食物中毒是由肉毒杆菌释放的肉毒毒素引起严重的神经肌肉中毒症状。该病初期常因临床表现为急性胃肠道中毒症状引起误诊而耽误治疗,严重者导致患者死亡。及早明确诊断和临床对症治疗是成功救治该病的关键。该文总结分析1例肉毒杆菌食物中毒患者的急诊救治过程。经过详细询问该患者的发病史和进食史,进行全面的体格检查、常规检验、影像辅助检查和实验室血浆肉毒毒素检测分析并结合临床症状,该患者确诊为肉毒毒素中毒。在未明确肉毒毒素亚型情况下,对患者大剂量注射A、B型抗肉毒毒素,辅助抗感染和营养恢复神经功能的综合治疗取得较好的治疗效果。患者发病第7日症状好转,救治26 d后康复出院。

Botulism food poisoning is characterized with severe neurotoxic symptoms induced by botu-linum toxin released by botulinum. Constantly,patients with botulism food poisoning could be misdiagnosed or receive delayed treatment due to gastrointestinal symptoms as early clinical manifestations,even leading to death. Therefore,early diagnosis and effective treatment determine the success of fighting against this disease. In this article,the diagnosis and treatment of one case of botulism food poisoning were retrospectively reviewed. After detail inquiry of onset and dietary habit,comprehensive physical examination,routine and imaging test, plasma botulinum toxin detection and combined with clinical symptoms,the patient was diagnosed as botulinum toxin poisoning. In the absence of the exact subtype of botulinum toxin,combined therapy of a large-dose injec-tion of types A and B anti-botulinum toxin,anti-infection therapy and nutritional recovery of neurological func-tion can achieve desirable therapeutic effect. The symptoms were improved at 7th days after treatment. The pa-tient was discharged after 26 days treatment.