急性重度酒精中毒的抢救及护理

大量饮酒后致乙醇急性中毒，严重者呼吸循环衰竭，肝脏和中枢神经系统损坏．甚至造成死亡。我院近3年共收治41例重度以上酒精中毒病人．现将其救治及护理体会报道如下。 1．临床资料 41例中，男36例，女5例，年龄最小12岁，最大71岁，平均41．5岁．一次性过量饮酒在500ml以上28例，一天连续2次以上饮酒500ml以上者18例．饮酒在500—700m15例．所有中毒患者均有不同程度昏迷和血压低于正常者，脉膊细弱36例，本组病人均有小便失禁和不同程度的呕吐，面色苍白，其中3例合并自发性脑出血．6例高血压脑病．1例急性心肌梗死．     

1例新生儿急性酒精中毒抢救及护理

总结1例急性酒精中毒新生儿的抢救与护理。密切监测生命体征,低流量头罩方式予以氧气吸入;禁食禁水,积极开通静脉通路,补液维持水电解质平衡;尽早使用纳洛酮解毒,能量合剂加速酒精氧化,谷胱甘肽及肝泰乐保肝治疗,里尔统营养心肌;予以洗胃以及清洁洗肠减少酒精吸收;监测血糖;吸痰保持呼吸道通畅;利尿及人工辅助通便促进排泄;皮疹护理;营养支持和注意保暖。经过3天的积极治疗与护理,患儿病情稳定出院。     

1例酒精中毒病人的抢救及护理

1病例介绍病人,女,82岁,2011年8月26日08：00,因误服75%乙醇约400mL,当时感到口腔及上腹部不适,而后呕吐胃内容物,家人发现误服,20min～30min送入我院急诊科。     

急性酒精中毒的临床抢救与护理体会

目的：通过对急性酒精中毒患者临床护理,达到提高疗效,缩短疗程,减少并发症的目的,总结急性酒精中毒的互利心得。方法：对120例酒精中毒患者进行催吐、快速建立静脉通道,并发症处理,改善通气功能,保证患者安全。结果：120例患者经治疗后3小时内神志转清,115例平均观察2天痊愈出院,5例患者因出现脑出血而转院。结论 通过对急性酒精中毒患者的临床护理,可以达到提高疗效、缩短疗程、减少并发症的目的。     

急性酒精中毒致呼吸循环衰竭1例的抢救与护理

20 0 1年 12月我们成功抢救急性重度酒精中毒致呼吸循环衰竭 1例 ,报道如下。1　病例简介患者男 ,46岁。因自服白酒 80 0ｇ3ｈ,呼之不应 2ｈ ,于 2 0 0 1年 12月 2 7日下午 4时 30分来诊。入院查体 :深昏迷状态 ,双瞳孔等大等圆 0 2ｃｍ ,球结膜及双侧视乳头水肿 ,鼾声呼吸 ,1     

纳洛酮抢救急性酒精中毒的护理体会

急性酒精中毒是急诊科常见的急性中毒性疾病,就诊者多数已出现恶心呕吐,情绪不稳定,意识状态及生命体征改变等。我科自2000年1月至2005年12月共抢救急性酒精中毒126例。经纳洛酮等综合抢救治疗,严密观察病情,精心护理,效果满意,均痊愈出院。1临床资料1.1一般资料急性酒精中毒患     

急性酒精中毒的急救与护理

酒的有效成分是酒精（乙醇），白酒含酒精40％-60％，酒精对人体中枢神经系统有抑制作用．一次饮酒过量即会导致神经精神症状为主的疾病，称酒精中毒。酒精中毒不仅给患者健康形成损害，重度酒精中毒还可危及生命，同时也是影响社会安定的因素。由于很多患者发病急，病情重，精神症状突出，不配合检查和治疗，给医院急诊工作增加了很大难度，是急诊内科的常见疾病。江苏省泰州市人民医院急诊科2005年1月～2006年4月共抢救治疗急性酒精中毒28例，现报告如下。     

纳洛酮抢救重度急性酒精中毒的临床观察

纳洛酮是 196 0年合成的阿片受体特异拮抗剂 ,自 2 0世纪 70年代应用于临床以来 ,其临床应用范围越来越广 ,如非麻醉药物过量、休克、新生儿窒息、肥胖症、重度颅脑伤及脑血管意外等[1] 。现将我院2 0 0 1年 5月～ 2 0 0 1年 8月临床应用纳洛酮抢救重度急性酒精中毒 2 1例报告如下。1　资料与方法1.1　一般资料　本组 4 6例 ,其中男性 31例 ,女性15例 ;年龄 16～ 5 2岁 ,年龄中位数 2 6 .8岁 ;长期酗酒 13例 ,偶尔饮酒 33例。 4 6例均在一次性过量饮酒后 1h内就诊。首诊时均存在不同程度的意识障碍 ,其中昏睡 2 1例 ,浅昏迷 14例 ,中度昏迷 …     

急性酒精中毒抢救流程

急性酒精（乙醇）中毒系指饮酒所致的急性神经精神和躯体障碍。通常是指一次性饮大量乙醇类物质后对中枢神经系统的兴奋、抑制的状态。     

血液透析抢救急性危重酒精中毒临床研究

目的探讨急性危重酒精中毒的有效抢救方法.方法对急性危重酒精中毒昏迷病人,采用血液透析治疗和纳洛酮静脉滴注治疗,观察中毒病人清醒时间和治疗过程中并发症出现情况.结果血液透析组(治疗组)平均清醒时间为2.1h,较纳洛酮组(对照组)平均清醒时间9.36hr明显缩短,差异高度显著(P＜0.01);其并发症发生率,治疗组明显低于对照组,差异显著(P＜0.05).结论对危重酒精中毒病例的抢救,血液透析比纳洛酮治疗更为有效.     

Hypothermia and acute alcohol intoxication in Dutch adolescents: The relationship between core and outdoor temperatures

Purpose: To investigate hypothermia and its potential association with core and outdoor temperatures in adolescents suffering from acute alcohol intoxication. Methods: Data were derived from the Dutch Pediatric Surveillance System, which monitors alcohol intoxication among all Dutch adolescents. Adolescents < 18 years of age with a positive blood alcohol concentration (BAC > 0 g/l) were included. This resulted in an analysis of data from the years 2011 to 2015 that were obtained through a total of 967 questionnaires. Results: This study revealed small but significantly lower core temperatures in winter time (35.59°C [96.06°F]) versus summer time (35.83°C [96.49°F]). These differences could not be attributed to the genders and ages of the patients. In winter time, 26.6% of the adolescents experienced mild hypothermia, with body temperatures of 32.00–34.99°C (89.60–94.98°F), compared to 18.0% during the summer. Although not significant, amounts of time spent in reduced consciousness, hospitalized and receiving intensive care were prolonged in adolescents with lower core temperatures. Conclusions: This article is the first to describe this trend of hypothermia among alcohol-intoxicated Dutch adolescents admitted during winter time. These findings are important for awareness of this issue and can be used for prevention strategies in the future.     

Breath analyzer screening of emergency department patients suspected of alcohol intoxication

Background

Acute alcohol intoxication is a frequent cause of emergency department (ED) visits. Evaluating a patient’s alcohol intoxication is commonly based on both a physical examination and determination of blood alcohol concentration (BAC).

Objective

To demonstrate the feasibility and usefulness of using a last-generation infrared breath analyzer as a non-invasive and rapid screening tool for alcohol intoxication in the ED.

Methods

Adult patients suspected of acute alcohol intoxication were prospectively enrolled over 10 days. Breath alcohol concentrations (BrAC) were measured using a handheld infrared breath analyzer. BAC was determined simultaneously by automated enzymatic analysis of a venous blood sample. The relationship between BAC and BrAC values was examined by both linear regression and Bland-Altman analysis.

Results

The study included 54 patients (mean age 40 ± 14 years, sex ratio M/F of 3/1). Breath and blood alcohol concentrations ranged from 0 to 1.44 mg/L and from 0 to 4.40 g/L (0–440 mg/dL), respectively. The mean individual BAC/BrAC ratio was 2615 ± 387, 95% confidence interval 2509–2714, which is 30% higher than the legal ratio in France (2000). The correlation between both measurements was excellent: r = 0.95 (0.92–0.97). Linear regression revealed BAC = 0.026 + 1.29 (BrAC × 2000) and BAC = 0.026 + 0.99 (BrAC × 2615). Mean BAC-BrAC differences and limits of agreement were 0.49 g/L [−0.35, 1.34] (or 49 mg/dL [−35, 134] and 0.01 g/L [−0.68, 0.71] (or 1 mg/dL [−68, 71]), for the 2000 and 2615 ratios, respectively.

Conclusion

The calculated conversion coefficient provided a satisfactory determination of blood alcohol concentration. Breath alcohol testing, using appropriate BAC/BrAC conversion, different from the legal BAC/BrAC, could be a reliable alternative for routine screening and management of alcohol intoxication in the ED.     

Effectiveness of a brief intervention with and without booster session for adolescents hospitalized due to alcohol intoxication

Background: The Hart-am-LimiT (HaLT) project is a brief intervention program for adolescents hospitalized due to alcohol intoxication in Germany.

Objective: To test whether a booster session has an impact on participants’ drinking behavior compared with the standard HaLT program.

Methods: On the morning after their admission due to alcohol intoxication, 411 adolescents in the Federal State of Bavaria were interviewed between October 2008 and January 2010 and socio-demographic data and information on previous drinking behavior were recorded (t1). Eleven to 25 months (M?=?16.4) after their hospital treatment, 106 adolescents completed an online questionnaire (t2).

Results: Subgroup analysis (ANOVA with repeated measurements) indicated that adolescents who took part in the booster session did not increase episodic heavy drinking (EHD; t1: M?=?1.68 EHD d; t2: 1.59 EHD d) in contrast to the non-participating group (t1: M?=?1.08?d EHD; t2: 2.66?d EHD; F?=?4.383, p?=?0.039).

Conclusion: Considering the study’s limitations (e.g. no randomization, low response rate, etc.), the results indicate a positive effect of a booster session following a brief intervention for adolescents who have been treated in hospital due to alcohol intoxication. Adolescents should therefore be motivated and encouraged to participate in booster sessions.     

急性有机磷农药中毒患者肌钙蛋白-I的变化

目的 探讨急性有机磷农药中毒患者心肌肌钙蛋白-I(cTn-I)的变化。方法 利用化学发光免疫测定法对114例急性有机磷中毒患者cTn-I水平进行测定，并观察患者心脏功能的改变。结果 急性有机磷中毒患者cTn-I水平均有不同程度升高，其升高与中毒程度呈正相关，并随病情缓解呈恢复趋势。结论 急性有机磷中毒患者的病情与cTn-I浓度的变化密切相关，监测急性有机磷农药中毒患者cTn-I的水平有重要的临床意义。     

中西医结合抢救急性氟乙酰胺中毒30例

目的：观察中西医结合抢救急性氟乙酰胺中毒的疗效。方法：对３０例急性氟乙酰胺中毒患者采用西医常规疗法，包括洗胃、乙酰胺解毒、镇静解痉、吸氧、纠正酸中毒及营养支持等，同时加服中药大黄及羚角钩藤汤治疗。结果：治愈２９例，死亡１例，治愈率９６．６７％，平均住院时间８．５日。伴抽搐的２５例患者经治疗当日抽搐停止１８例，第２日抽搐停止６例，第３日抽搐停止１例。结论：中西医结合抢救急性氟乙酰胺中毒疗效较好     

Nontraumatic rhabdomyolysis with short‐term alcohol intoxication – a case report

Alcohol‐induced rhabdomyolysis is a potentially life‐threatening condition due to the probability of progression to acute renal injury. Patients admitted to emergency department with acute alcohol intoxication should always undergo blood and urine tests for early recognition and treatment of rhabdomyolysis.     

血液净化救治毒鼠强中毒患者的临床研究

目的探索血液净化对毒鼠强中毒的治疗价值。方法应用血液净化方法治疗10例毒鼠强中毒患者,进行疗效总结;并与既往常规治疗（未血液净化）的7例患者疗效进行比较。结果血液净化治疗后患者血液毒鼠强浓度、心肌酶、APACHEⅡ评分、脑电图评分较治疗前均有明显降低（P均<0.01);血液净化组与常规非血液净化治疗组患者比较,相同时期(入院第5日)内血液毒鼠强浓度下降值〔分别为(82.3±21.7）μg／L和(27.9±14.2)μg／L〕有显著差异(P<0.01),意识转清醒及抽搐停止时间〔血液净化组分别为(5.7±2.6)小时和(0.9±0.7)日,非血液净化组分别为(16.2±10.1）小时和(4.5±3.7)日〕均显著提前(P均<0.01)。结论血液净化治疗毒鼠强中毒比常规方法更有效。     

电动洗胃机改良洗胃法在抢救口服中毒患者中的应用

目的对电动洗胃机洗胃法进行改良，以提高洗胃质量。方法将86例口服有机磷农药实施电动洗胃机洗胃的患者随机分为实验组和对照组，各43例。实验组采用改良洗胃法，对照组采用传统法。对两组间洗胃质量进行比较。结果两组在洗胃时间和洗胃液总量、洗胃过程顺利与否、胃黏膜出血情况的比较，差异均有统计学意义（均P〈0．05）。结论改良后的洗胃法可更有效固定胃管、清除毒物、缩短洗胃时间，并能防止洗胃术中及术后呕吐的发生。     

不同剂量纳络酮治疗急性乙醇和安定混合中毒性昏迷临床研究

目的：探讨不同剂量纳络酮对本地区急性昏迷（饮酒的同时服用较大剂量的安定）患者的临床应用效果。方法：①应用前瞻性研究方法,将急诊就医和院前呼救昏迷时间在6h以内的急性昏迷患者作第一次Glasgow评分,Glasgow评分在6～10分的急性昏迷患者296例列入本研究。②将所有患者随机分成对照组和纳洛酮治疗1组、2组、3组和4组。在对原发病治疗的同时,对照组使用5％葡萄糖注射液250ml加美解眠注射液200mg静脉滴注,治疗组分别加用纳洛酮0．4mg,1．2mg,2．0mg和5．0mg稀释到20ml后静脉推注,每2小时1次。对人选患者取动脉血进行动脉血气分析、取静脉血检测电解质等,根据资料作第一次APACHE-II评分,在24和48h分次进行APACHE-II评分。③病例观察指标：认真观察记录患者苏醒时间,治疗后1／2、1、2、4、8、12、24、48和72hGlasgow评分和血压等。结果：各组2种评分无统计学意义,治疗组完全苏醒时间与对照组相比差异分别有统计学意义（P〈0．01）,且头痛,肌肉松弛无力等症状减少,治疗3组和治疗4组差异无统计学意义（P〉0．05）。结论：纳络酮对乙醇和镇静剂联合中毒所致的急性昏迷,具有较强地催醒作用,在一定的范围内存在剂量的依赖关系。