摘要： 目的 探讨急性毒蕈中毒的临床表现、临床分型以及临床治疗。方法 对89例急性毒蕈中毒患者的临床资料进行回顾性分析。将52例肝损害患者随机分为对照组（21例）和研究组（31例），对照组采用单纯血液灌流或血浆置换治疗，研究组采用血液灌流联合血浆置换治疗，比较2组患者的治疗效果。结果 共收治急性蘑菇中毒患者89例，其中52例合并肝脏损伤，7例合并肾脏损伤。入院时均给予洗胃、催吐、导泻、灌肠，迅速排出体内尚未吸收的毒物，给予对症处理和解毒治疗，必要时行血液净化治疗。治疗后，研究组重症毒蕈中毒患者丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、白蛋白等指标以及死亡率、治愈率均显著优于对照组（P<0.05）。结论 重视急性毒蕈中毒的临床分型有利于有效救治，尽早发现急性毒蕈中毒，快速诊断，尽快有效对症治疗，必要时尽早运用血液净化等综合治疗，可以提高疗效、缩短病程、降低死亡率、改善患者预后。

急性毒蕈中毒的临床分析

赵航, 赵敏

中国医科大学附属盛京医院急诊科, 沈阳 110004

收稿日期:2019-09-16出版日期:2020-05-30发布日期:2020-05-13
通讯作者:赵敏E-mail:zhaom@sj-hospital
作者简介:赵航(1987-),男,医师,硕士.
基金资助:辽宁省自然科学基金（201602879）


关键词: 毒蕈中毒, 临床分型, 临床治疗
Abstract: Objective To investigate the clinical manifestation,clinical classification,and treatment of acute mushroom poisoning. Methods Clinical data of 89 patients with acute mushroom poisoning were retrospectively analyzed,and 52 patients with liver injury were randomly divided into a control group(n=21) and a study group(n=31). The patients in the control group were treated with hemoperfusion or plasma exchange,and those in the study group were treated with hemoperfusion combined with plasma exchange. The therapeutic effects in the two groups were compared. Results Among the 89 patients with acute mushroom poisoning,52 had liver injury and 7 had kidney injury as complications. Gastric lavage,induction of vomiting,catharsis,enema,induction of rapid discharge of the unabsorbed toxicant,symptomatic treatment,and detoxification treatment were performed,and blood purification was performed when necessary. After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and albumin,mortality rate, and cure rate in the study group were significantly better than those in the control group(P<0.05). Conclusion Clinical classification of acute mushroom poisoning is helpful in improving the treatment efficacy. Early detection,rapid diagnosis,prompt and effective symptomatic treatment,and early blood purification when necessary can improve treatment efficacy,shorten the disease course,reduce mortality,and improve the prognosis of patients.
Key words: mushroom poisoning, clinical classification, clinical treatment
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