目的:分析急性百草枯中毒患者早期血清心肌酶的表达水平,探讨其对预测发病后猝死的意义.方法:检测52例急性百草枯中毒患者(中毒时间＜24 h)入院时的心肌酶谱.根据患者的临床结局分为猝死组(生存时间≤1 d)和非猝死组(即生存时间＞1 d).比较两组患者入院时的心肌酶谱和APACE Ⅱ评分.结果:猝死组心肌酶水平显著高于非猝死组(P＜0.01),猝死组的中毒剂量显著大于非猝死组(P＜0.01).结论:急性百草枯中毒猝死组患者的心肌酶活性显著增高,且与中毒剂量相关;中毒后血清心肌酶活性的显著升高可能是发生猝死的一个预警指标.

Objective:To investigate the effects of high-dose ambroxol on serum TNF-α and IL-6 of patients with pulmonary injury caused by acute paraquat poisoning. Methods:Thirty-one patients with pulmonary injury caused by acute paraquat poisoning were randomly divided into treatment group (n=16) and control group (n=15). Both groups were treated with conventional therapy. Treatment group were given ambroxol 20 mg/(kg·d)intravenously guttae every 12 h for 3 days. Serum TNF-α and IL-6 were measured by ELISA before and after treatment,and lung injury score (LIS) was also assessed in all subjects. Results:Levels of serum TNF-α and IL-6,and LIS in both groups were significantly lower after treatment(P0.01). Furthermore,treatment group showed significantly more lower than control group (P0.05). Conclusion:High-dose ambroxol can inhibit exrpression of serum TNF-α and IL-6,reduce the degree of pulmonary injury caused by acute paraquat poisoning.

目的探讨护理程序在急性甲醇中毒急救护理中的合理运用。方法回顾性分析2004年5月11日发生在广州某区42人饮用甲醇超标假酒引起中毒在我院救治的临床资料。结果假酒中甲醇含量达16%～46%,饮用量50～2000ml,平均每人588.1ml,血中甲醇含量为0.03～23.60mmol/L,平均1.61mmol/L,临床诊断为观察对象17例,轻度急性甲醇中毒9例,重度急性甲醇中毒16例。采取综合救治护理后,痊愈35例(83.3%)、失明2例(4.8%)、伴有神经精神症状后遗症4例(9.5%)、死亡1例(2.4%)。结论及早清除体内甲醇,合理使用激素,保持呼吸道通畅,保护视神经与视网膜,加强心理护理,是这次抢救成功的关键。