新疆阿克苏地区儿童枸橼酸喷托维林中毒27例临床分析

Clinical analysis of 27 children with pentoxyverine citrate poisoning in Akesu area of Xinjiang

目的探讨儿童枸橼酸喷托维林中毒的临床特征,总结分析救治过程中的器官功能损害及预后,提高对此类药物中毒的认识。方法收集2016年10月-2018年12月期间我院救治的27例枸橼酸喷托维林中毒儿童的临床资料,对临床诊疗过程进行分析和经验总结。结果 27例中毒患儿年龄主要分布在2-5岁,此年龄段占比达(92.59%)。中毒表现主要为:阿托品效应27例(100%)、椎体外系反应24例(88.89%)、意识障碍20例(74.07%)、惊厥17例(62.96%),严重者出现呼吸抑制1例(3.7%)。器官功能损害:心肌酶谱轻度增高10例(37.04%),心电图异常16例(59.26%);肝、肾功异常8例(29.63%);血白细胞计数、CRP、PCT升高3例(11.11%);11例(40.74%)惊厥患儿头颅磁共振均未见明显异常。除1例死亡外,其余26例均恢复良好出院。结论枸橼酸喷托维林中毒的主要临床特征表现为神经系统症状,大多数以惊厥发作被收治,易被误诊为中枢神经系统疾病,此药除1例误服剂量过大导致死亡,儿童枸橼酸喷托维林中毒大部分预后良好。

Objective To investigate the clinical characteristics of pentoxyverine citrate poisoning in children, in order to summarize and analyze the organ function damage and prognosis in the course of treatment, and improve the understanding of pentoxyverine citrate poisoning. Methods The clinical data of 27 children with pentoxyverine citrate poisoning treated in our hospital from October 2016 to December 2018 were collected, and the clinical diagnosis and treatment process were analyzed and summarized. Results The age of 27 children with poisoning was mainly between 2 and 5 years old, which accounted for 92.59%. The main manifestations of poisoning were atropine effect in 27 cases(100%), extrapyramidal system reaction in 24 cases(88.89%), consciousness disorder in 20 cases(74.07%),convulsion in 17 cases(62.96%)and respiratory depression in 1 case(3.7%). Organ dysfunction: mild increase of myocardial enzymes in10 cases(37.04%), abnormal electrocardiogram in 16 cases(59.26%), abnormal liver and kidney function in 8 cases(29.63%), elevated white blood cell count, CRP and PCT in 3 cases(11.11%) and no obvious abnormality of head magnetic resonance imaging in 11 convulsions. Except for one death, the other 26 cases recovered well and discharged from hospital. Conclusion The main clinical characteristics of pentoverine citrate poisoning are nervous system symptoms. Most of them are admitted with convulsion attack, which is easy to be misdiagnosed as central nervous system disease. Except for one case of death caused by overdose of the drug, most of the prognosis of children with pentoverine citrate poisoning is good.