急性腈菌唑中毒救治临床分析

Clinical Analysis of Acute Toxicity of Myclobutanil

目的探讨急性腈菌唑中毒的发病机制及治疗要点。方法对急性腈菌唑中毒1例的临床资料进行回顾性分析。结果本例因口服腈菌唑48 h,周身发绀1 h就诊。入院后予呼吸机辅助呼吸、床旁连续性血液滤过、有创血流动力学监护、补液、抗感染、保护胃肠道功能、营养支持等综合治疗,患者病情短暂好转,后因消化道大出血,家属放弃治疗后死亡。结论临床尚无腈菌唑中毒的特异性解毒药物,早期予综合治疗的同时对胃肠功能进行积极的支持和干预有助于降低消化道大出血的发生风险。

Objective To discuss the pathogenesis and treatment experience of acute toxicity of myclobutanil. Methods The retrospective analysis was performed on clinical data of one patient with acute myclobutanil toxicity. Results The patient presented to our hospital because of systemic cyanosis for 1 h after taking myclobutanil orally 48 h before. The patient＇s condition was temporarily improved following a series of comprehensive treatments including mechanical ventilation,bedside continuous veno-venous hemofiltration,invasive hemodynamic monitoring,fluid infusion,anti-infection treatment,protection of gastrointestinal function and major visceral organs,and nutritional support. The patient died because of gastrointestinal hemorrhage after the family forewent treatment. Conclusion Pathogenesis of myclobutanil toxicity remains unclear. No specific antidotes are available to date. However,early comprehensive treatment as well as active support and intervention of gastrointestinal function can help reduce the risk of massive gastrointestinal bleeding.