氯氮平中毒继发急性肺损伤/急性呼吸窘迫综合征的抢救体会

目的:探讨氯氮平中毒继发急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)有效的治疗方法。方法:总结分析16例氯氮平中毒继发ALI/ARDS患者的临床表现和治疗方法。患者在中毒后6～144h出现ALI/ARDS表现,予气管插管、机械通气,抗胆碱药物治疗及血液灌流等综合治疗。结果:本组患者均治愈,平均住院时间(14±1.6)d;机械通气时间平均(134±12)h,中毒后(48～96)h意识转清。结论:氯氮平中毒继发的急性肺损伤/急性呼吸窘迫综合征主要与肺水肿、吸入性肺炎及氯氮平对肺组织的直接损伤作用有关。早期进行机械通气联合血液灌流和合理抗胆碱药物的,是治疗重度氯氮平重度并发急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)的有效方法。

Experience of treating patients with acute lung injury/acute respiratory distress syndrome caused by clozapine poison

Objective：To explore the effective therapeutic method of in clozapine poisoning accompany with acute lung injury/acute respiratory distress syndrome patients. Method.. Sixteen patients clinical data of clozapine poisoning accompany with acute lung injury/acute respiratory distress syndrome were collected and analysed. All patients displayed acute lung injury/acute respiratory distress syndrome signs 6- 144 hours after clozapine poison- ing and were treated with tracheal cannula, mechanical ventilation, Anticholinergics and hemoperfusion et al. Re- suit：All Patients were cured and average stay was 14 ± 1.6 days, average ventilation time was average 134 ± 12 hours, consciousness recovered 48-96 hours after hospitalization. Conclusion：Acute lung injury/acute respiratory distress syndrome caused by clazapine poisoning concerned with pneumonedema, aspiration pneumonia and direct injury of clozapine. Early mechanical ventilation, hemoperfusion and giving anticholinergics reasonably were effec- tive methods of curing severe clozapine poisoning accompany with acute lung injury/acute respiratory distress syn- drome.