河豚鱼中毒致呼吸麻痹的临床实质与抢救措施

目的 探讨河豚鱼中毒致呼吸麻痹的临床实质与抢救措施。方法 总结分析33例诊断明确的河豚鱼中毒患者采取不同抢救方法与效果。结果 使用阿托品解毒及麻用呼吸兴奋剂者无明确的药物治疗作用，及时建立人工气道维持有效呼吸与生命支持等综合措施抢救．轻、中症患者存10～14h左右痊愈，极重症患者也可在19～24h内恢复自主呼吸。结论 河豚毒选择阻断神经与肌肉的电生理活动，呈非去极化型箭毒碱样作用．致呼吸动力障碍，与呼吸中枢无关，M胆碱能受体阻滞剂阿托品及中枢兴备剂均无明确使用指征，维持有效通气等综合治疗可达到满意疗效。

Clinical nature of tetrodotoxin intoxication and the measures for emergency rescue

Objective To define the clinical nature of tetrodotoxin intoxication and explore the measures for its emergency rescue. Methods The emergency rescue measures and outcomes of 33 cases tetrodotoxin intoxication were reviewed. Results No obvious effects were observed in these patients after administration of atropine or application of respiratory stimulant, but implementation of mechanical ventilation and comprehensive life support measures resulted in successful rescue of mild to moderate cases within 10 to 14 h, and recovery of spontaneous respiration was achieved in critical cases in 19-24 h. Conclusion Tetrodotoxin selectively blocks the neuromuscular electrical activity, producing the effect of nondepolarizing curine and leading to failure of the respiratory drive without compromising the respiratory center. Atropine, a M-cholinergic receptor blocker, or central stimulants may fail to produce obvious effects, but comprehensive treatments including maintenance of effective ventilation can bring satisfactory effects.