血液净化与二巯丙磺钠联合治疗急性铊中毒2例临床分析

Clinical analysis on 2 cases of acute thallium poisoning with combined treatment using blood purification and sodium dimercaptosulfonate

目的探讨急性铊中毒的临床特征、治疗方法及预后。方法对2例急性铊中毒病例临床资料进行回顾性分析,观察其临床特征、血液净化与二巯丙磺钠的治疗效果及预后。结果 2例急性铊中毒患者均有胃肠道症状、周围神经病及脱发的典型三联征;治疗前血铊分别为200.6、712.7μg/L,尿铊分别为5 206.4、11 050.2μg/24 h。2例患者经血液净化与二巯丙磺钠治疗后,血铊分别下降至31.6、14.6μg/L,尿铊分别下降至175.2、265.3μg/24 h。2例患者预后较好,分别在治疗2、5个月复查显示,血铊分别为7.9、0.6μg/L,尿铊分别为31.5、5.5μg/24 h。结论血液净化与二巯丙磺钠联合治疗对铊中毒有效。

Objective To investigate the clinical features,treatment methods and prognosis of acute thallium poisoning.Methods The clinical data of 2 cases of acute thallium poisoning were analyzed retrospectively to observe its clinical features,therapeutic effect of blood purification and sodium dimercaptosulfonate,and prognosis.Results The typical triads of clinical features of the two cases of acute thallium poisoning were gastroenteritis,polyneuropathy and alopecia.Before treatment,the blood thallium level was 200.6 and 712.7 μg/L and the urine thallium level was 5 206.4 and 11050.2 μg/24 h respectively.After the combined treatment using blood purification and sodium dimercaptosulfonate,the blood thallium decreased to 31.6 and 14.6 μg/L and the urine thallium decreased to 175.2 and 265.3 μg/24 h.The two patients had a good prognosis.The result of re-examination showed that blood thallium was 7.9 and 0.6 μg/L and the urine thallium was 31.5 and 5.5 μg/24 h respectively in 2 and 5 months later.Conclusion The combined treatment using blood purification and sodium dimercaptosulfonate is effective for acute thallium poisoning therapy.