62例重症鱼胆中毒急性肾功能衰竭救治探讨

鱼胆中毒是一个严重的临床急症,可于服胆后1～4d内迅速发生急性肾衰、肝脏损害、心肌损害等致命性的多系统器官功能衰竭。临床上处理十分困难,病死率高。国内于1965年首次报告,在目前为止已达786例。其中重型中毒患者573例(简称国内组)。行血透治疗351例,腹透治疗66例、直肠透析治疗16例。转为慢性肾衰2例。死亡57例,死亡率9.9％。我院1987～1998-06共收治鱼胆中毒86例,其中重型中毒62例均有急性肾功能衰竭,鱼胆中毒的救治主要是重型     

腹膜透析抢救重症鱼胆中毒31例

鱼胆中毒自 1965年国内首次报道以来 ,至今已不下千余例。近年来 ,常规透析治疗鱼胆中毒已为医生所熟知 ,但仍有一定病死率[1] 。 1987～ 1995年 ,我们采用经皮穿刺、快速植管、腹膜透析的方法抢救重症鱼胆中毒 31例 ,全部获得成功 ,无一例死亡。1　临床资料1 1　一般情况　严重青鱼胆中毒致急性肾功能衰竭伴中毒性肝炎和中毒性心肌炎 31例。除消化道症状明显外 ,肾功能发生衰竭 ,并出现肝脏、心脏等其他系统脏器功能严重损害或衰竭的征象。男 2 0例 ,女 11例 ;年龄 2 0～ 73岁 (其中 60岁以上者占 2 3例 ) ,平均 54岁。无尿 3ｄ 16例 ,4ｄ …     

血液透析对鱼胆中毒致急性肾功能衰竭的救治作用

长期以来 ,我国南方许多地方常有鱼胆可治眼病之说 ,所以因吞服鱼胆发生中毒者常有报道。鱼胆中毒后首先出现消化道症状 ,继而出现肝损害 ,严重者短时间内出现急性肾功能衰竭。我院从 1992年以来 10年间共收治此类患者94人 ,并发急性肾功能不全者 80人 ,占 85 %。 80例患者经支持治疗、保肝治疗、血液透析等治疗后全部治愈 ,无 1例死亡 ,也无 1例转为慢性肾功能衰竭者。现报告如下。1　临床资料1 1　病例情况　 80例患者中 ,男 36例 ,女 5 8例。年龄1970岁 ,平均 5 2岁。服用方法 :生服 82例 ,其中冲酒服用3例 ,熟服 12例。服鲤鱼胆 31例 ,…     

鱼胆中毒抢救成功3例报告

鱼胆中毒在国外无报道 ,国内多有报道。主因在我国《本草纲目》中早有记载 :鱼胆味甘苦寒有毒 ,多作外用。民间流传鱼胆可明目止咳、清热解毒 ,故常有生食者治疗眩晕、眼疾、慢性支气管炎、高血压病等。我院近期救治 3例鱼胆中毒的患者 ,其临床表现不一 ,现报道如下。1　临床资     

血液灌流串联血液透析滤过抢救鱼胆中毒致多脏器损害1例

鱼胆因以“去火消炎”的民间偏方致患者自服引起严重脏器中毒损害,病死率高,抢救困难。我院2005年6月收治鱼胆中毒1例,经血液灌流串联血液透析滤过抢救取得了临床满意效果,现报告如下。     

急诊血透血管通路建立的方式与护理

急诊血透的患者大多是急性中毒和不同原因所致的急性肾衰。这类患者起病急,病情重,但大部分经数次血透治疗后可以痊愈。因此,临床上对这类患者行血透时,一般都采用桡足背动脉穿刺与大静脉置管的方式,建立临时性血管通路进行血透治疗。本文就38例急诊透析患者血管通路建立的方式与护理重点作一总结。1 临床资料1.1 一般资料 自1998年以来急诊透析的患者38例,其中毒蕈中毒8例、鱼胆中毒5例、农药中毒6例、术后急性肾衰3例、蜂蜇伤2例、安定中毒1例、酒精中毒1例、外伤性急性肾衰1例,另有11例为慢     

血液透析治疗毒蕈中毒致急性肾功能衰竭临床疗效观察

目的探讨血液透析治疗毒蕈中毒致急性肾功能衰竭的临床效果。方法对31例毒蕈中毒致急性肾功能衰竭患者及时采用血液透析治疗，观察临床疗效。结果经血液透析治愈30例，死亡1例，治愈率97％，死亡率3％。结论血液透析在治疗由毒蕈中毒，尤其是重型中毒引起的急性肾功能衰竭，疗效显著，并发症及后遗症少，值得临床推广运用。     

百草枯中毒的药物治疗研究进展

农药百草枯属剧毒除草剂,重度中毒患者可在短时间内死于多脏器功能衰竭;中度中毒时主要损害肺脏,患者发生急性呼吸窘迫综合征,后期多死于肺纤维化。因尚无特效解毒药,临床救治多以对症和支持治疗为主,病死率极高。寻求有效的治疗药物已成为百草枯中毒的研究热点。本文对临床救治中常用的及近年来新发现的对百草枯中毒有治疗作用的药物作一综述。     

鱼胆中毒的抢救与护理体会

鱼胆的毒性较大，毒理尚不清楚，鱼胆进入胃肠道后，首先到达肝脏，肾脏为主要的排泄途径，对肾脏的毒性最高，以肝肾中毒为甚，常可致死。我们收治鱼胆中毒10例，经抢救和护理，9例治愈，1例死亡。现将抢救与护理方法总结报告如下。     

急性鱼胆中毒神经并发症的探讨

1973～1976年我院收治急性鱼胆中毒5例,3例有明显神经症状。鉴于国内对急性鱼胆中毒的神经并发症尚少专文论述,现报道于下。 临床资料 本组5例,女3例,男2例。年龄最小12岁,最大67岁。病人皆为“清热”而吞服生鱼胆1～3个。出现     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.