甲基苯丙胺急性中毒的临床表现及救治

甲基苯丙胺（methamphetamine,MA,俗称＂冰毒＂）为违禁毒品,滥用MA可致严重的生理和心理障碍甚至危及生命。1例28岁男性患者,有吸食MA史1年余,每月平均吸食4～5次。患者出现躁动不安,意识障碍,四肢抽搐、牙关紧闭,每次发作3～5min,4h共发作5～6次,遂入院。查体：T38.5℃,BP140/90mmHg,R30次/min,HR120次/min,谵妄、意识不清,瞳孔对光反射迟钝,躁动不安,全身大汗。毒物分析结果：血清MA0.2μg/ml,血清苯丙胺0.1μg/ml;尿MA12.3μg/ml,尿苯丙胺1.3μg/ml,MA的血清浓度达致死剂量。给予气管插管,呼吸机辅助通气及对症、支持治疗。2d后神志转清,恢复自主呼吸。在ICU住院6d出院。

Clinical manifestations of acute methamphetamine poisoning and management

Methamphetamine,commonly called as ice （MA）,is illegal drugs. MA abuse could cause severe psychiatric and physical disorders even life-threatening reactions. A 28-year-old man had a history of MA abuse for one year and more and he took MA four to five times every month on average. The patient experienced 5~6 episodes of agitation,confusion,convulsion of extremities,and trismus within 4 hours,and each episode lasted for 3~5 minutes. He subsequently was admitted to hospital. Physical examination showed temperature of 38.5℃,a BP of 140/90 mm Hg,a respiratory rate of 30 breaths/min,and a heart rate of 120 beats/min,delirium,confusion,sluggish light reflex,agitation,and generalized polyhydrosis. Toxicological analysis revealed the following results：serum MA 0.2 μg/ml,serum amphetamine 0.1 μg/ml,urine MA 12.3 μg/ml,urine amphetamine 1.3 μg/ml. MA serum concentration reached a fatal dose of the drug. He underwent endotracheal intubation and ventilator support. Meanwhile he was given symptomatic and supportive treatments. Two days later,he returned to consciousness and spontaneous respiration. The patient was discharged after six days of hospitalization in the intensive care unit.