急性甲醇中毒的临床救治

目的救治饮用甲醇超标假酒引起中毒的42例患者，对急性甲醇中毒的临床救治进行综合分析。方法分析2004年5月11日发生在广州某区多人饮用甲醇超标假酒引起中毒在我院救治的临床资料，患者血中甲醇含量用气相色谱顶空进样法测定；临床诊断标准参照职业卫生标准(GBZ53-2002)和相关资料，临床诊断分为观察病例、轻度和重度中毒；采取8项措施进行救治。结果假酒中甲醇含量达16％～46％，我院收治的42例患者中男40例、女2例，年龄22～80岁，平均46．1岁，饮用假酒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，临床诊断为观察病例17例、轻度急性甲醇中毒9例、重度急性甲醇中毒16例。采取8项措施救治后，有35名患者痊愈(83．3％)、2例失明(4．8％)、4例(9．5％)伴有神经精神症状后遗症、死亡1例(2．4％)。结论政府重视、启用广州市突发性公共卫生事件应急预案(修订稿)、指定有综合救治能力的中毒控制中心作为专门救治医院、及早清除已进入体内的甲醇、纠正酸中毒、应用叶酸解毒、合理使用激素、保护视神经与视网膜、综合对症治疗及加强监护，是这次抢救甲醇中毒成功的关键。

Clinical cure for acute methanol poisoning

OBJECTIVE: To analyze the treatment of 42 patients with acute methanol poisoning because of drinking alcohol containing methanol. METHODS: Clinical data of 42 cases of methanol poisoning were collected and analyzed. Methanol concentration in drinking alcohol and blood was determined by gas chromatography (GC). National standard for occupational medicine (GBZ53-2002) was used to diagnose the cases. RESULTS: The methanol concentration in the alcohol was 16% approximately 46%. 42 Patients (40 males, 2 females), at age of 46.1 (22 approximately 80), took 588.1 ml (50 approximately 2,000 ml) of the alcohol. The average methanol concentration in blood was 1.61 mmol/L (0.03 approximately 23.60 mmol/L). According to clinical diagnosis, there were 17 observed cases, 9 mild acute toxication, and 16 severe acute toxication. Among them, 35 (83.3%) patients were recovered, 2 (4.8%) blind, 4 (9.5%) with neuropsychic sequela and 1 (2.4%) dead after adopting 8 cure measures. CONCLUSION: To start using emergency plan for public health events suddenly happened, designate a special treatment hospital, clear blood methanol as soon as possible, correct acidosis, adequately administer folacin and hormone, protect optic nerve and retina, and take comprehensive symptomatic treatment as well as strict monitoring are the keys of clinical cure.