广西急性毒鼠强中毒应急救治方法的研究（毒鼠强解毒鸡尾酒疗法）

目的：对广西急性毒鼠强中毒病例进行总结，探讨其应急救治方法(毒鼠强解毒鸡尾酒疗法)，更好地指导毒鼠强中毒的抢救工作。方法：对广西职业病防治研究所住院急救的79例急性毒鼠强中毒者，结合作者对发生于全自治区30起共767例群体性急性毒鼠强中毒者的现场抢救指导或急性毒鼠强会诊的应用效果进行整理分析。其应急救治方法主要为：①排毒：尽早催吐、反复彻底洗胃；及早使用大剂量利尿剂或血液净化疗法清除胃内或血中的毒鼠强；②抗惊厥和拮抗毒鼠强：使用苯巴比妥钠，按抗惊厥量，每间隔4h静脉注射1次，同时配合大剂量静脉注射安定和纳络酮；⑧非特异解毒综合疗法：以使用自由基清除剂还原型谷胱甘肽和1，6-二磷酸果糖为主；配用大剂量激素和超大剂量维生素B。；危重症中毒患者加用乌司他丁和脑活素；慎用二巯基丙磺酸钠；①积极防治脑水肿，早期使用脱水剂，20％甘露醇并间隔使用30％～50％葡萄糖溶液；酌情配用高压氧治疗和量子血治疗；⑤按内科急重症常规进行对症治疗和支持疗法，酌情配合使用细胞活化药物及抗生物氧化剂。结果：经采用以上五方面的积极应急救治后，846例中毒者无一例死亡。结论：通过采用以上五方面的应急救治方法(毒鼠强解毒鸡尾酒疗法)，能有效的降低毒鼠强中毒的病死率。

COMPREHENSIVE THERAPIES ON ACUTE TETRAMINE POISONING ANALYSIS OF 846 CASES

Objective:To analyze the clinical characteristics of and explore the possible therapies for tetramine poisoning, for which no specific antidotes are available presently Methods:846 cases of acute tetramine poisoning admitted to hospitals in Guangxi Province from 1999 to 2002 were analyzed All patients were diagnosed by detection of tetramine in whole blood, urine or gastric lavage fluids with Gas Chromatographer, and observation typical signs and symptoms of tetramine poisoning Emergency treatments included: emesis as soon as possible and complete gastric lavage; blood purification and administration of high dosage diuretics in early stage; application of anti convulsion drug(mainly phenobarbital) and non specific therapeutic antidotes (a cocktail of 6 antidotes); activel prevention of cerebral edema and infection; rational use of oxygen, high pressure oxygen or ultraviolet blood irradiation and oxygenation (UBIO); supportive measures and relief of symptoms Results:After the multi measures were carefully taken, no cases of patients in this group died Conclusion:The diagnosis of tetramine poisoning should be based on the evidence of tetramine exposure Comprehensive measures are effective for the treatment of tetramine poisoning