严重苯酚烧伤合并急性中毒一例

One patient with severe phenol burn complicated with acute poisoning

2018年4月26日,浙江大学医学院附属第二医院收治1例经外院转入的严重苯酚烧伤合并急性中毒的55岁男性患者。该患者伤后很快出现意识模糊、躁动等中枢神经症状及无尿、呼吸功能衰竭,经院前自救及院内创面洗消减少酚吸收、快速大量补液及血液透析+血液灌流、连续性肾脏替代治疗加快酚排泄、脏器功能维护等一系列措施,中毒症状得到有效缓解,最终得以成功救治,于伤后29 d出院。本病例提示,早期血液透析联合血液灌流及连续性肾脏替代治疗是救治严重苯酚烧伤合并急性中毒的有效手段。

On April 26,2018,a 55-year-old male patient with severe phenol burn complicated with acute poisoning was admitted to the Second Affiliated Hospital of Zhejiang University School of Medicine.The patient quickly developed the symptoms of central nervous system including blurred consciousness and restlessness,anuria,and respiratory failure.After self-rescue before admission and a series of measures in hospital including wound decontamination to reduce phenol absorption,rapid massive infusion and hemodialysis+hemoperfusion,continuous renal replacement therapy for speeding up phenol excretion and organ function maintenance,the poisoning symptoms were effectively alleviated,and the patient was finally rescued successfully and discharged on post injury day 29.This case suggests that early hemodialysis combined with hemoperfusion and continuous renal replacement therapy are effective methods for treating severe phenol burn complicated with acute poisoning.