疑似乙二醇中毒1例的诊治思考
摘要
<正>随着汽车普及化,乙二醇误服中毒事件时有发生,乙二醇中毒往往导致患者肾、心、脑等多器官功能衰竭而死亡。但一部分中毒患者处于意识障碍状态,无法陈述病史,对早期诊断造成困难。本文报道1例疑似乙二醇中毒病例,并对其早期诊断进行思考和探讨。患者男,80岁,退休人员,因"昏迷2 h"于2016年8月10日急诊入院。患者于入院前2 h,被家人发现呼之不应,遂由家人拨打"120"接诊。既往史
引文
1 Nagesh IV,Koley KC,Sen S,et al.Ethylene glycol poisoning[J].Med J Armed Forces India,2015,71(Suppl 1):36-38.
2谭彬昕,董瑶瑶,张志坚.急性乙二醇中毒44例文献检索报告[J].海南医学,2015,26(7):1065-1067.
3 Tanasescu A,Macovei RA,Tudosie MS.Outcome of patients in acute poisoning with ethylene glycol-factors which may have influence on evolution[J].J Med life,2014,7(3):81-86.
4 Alhamad T,Blandon J,Meza AT.Acute kidney injury with oxalate deposition in a patient with a high anion gap metabolic acidosis and a normal osmolal gap[J].J Nephropathol,2013,2(2):139-143.
5朱士胜,黄伟,赵鹏,等.SD大鼠急性乙二醇中毒的法医病理学研究[J].重庆医科大学学报,2014,39(1):43-46.
6黄玉红,王轶淳,王炳元,等.酒精性肝病血清乙醇脱氢酶的变化[J].中华肝脏病杂志,2002,10(1):24.
7 Cooper CM,Baron JM.Case 4-2015.A 49-year-old man with obtundation followed by agitation and acidosis[J].N Engl J Med,2015,372(5):465-473.
8 Hopper K,Epstein SE.Falsely increased plasma lactate concentration due to ethylene glycol poisoning in 2 dogs[J].J Vet Emerg Crit Care(San Antonio),2013,23(1):63-67.
9 Riquier T,Geri G,Mongardon N,et al.False hyperlactatemia in lifethreatening ethylene glycol poisoning[J].Ann Fr Anesth Reanim,2014,33(4):79-81.
10 Schoen JC,Cain MR,Robinson JA.Adolescent presents with altered mental status and elevated anion gap after suicide attempt by ethylene glycol ingestion[J].Pediatr Emerg Care,2016,32(10):688-690.
11 Horinek EL,Kiser TH,Fish DN,et al.Propylene glycol accumulation in critically ill patients receiving continuous intravenous lorazepam infusions[J].Ann Pharmacother,2009,43(12):1964-1971.
12 Su Z,Stone RW,Zhu Y.Positive propylene glycol result in a patient with ethylene glycol poisoning[J].Clin Chem,2014,60(4):697-798.
13 T Theelen.Urine fluorescence in ethylene glycol poisoning[J].N Engl J Med,2007,356(19):2006-2007.
14 Tanasescu A,Macovei RA,Tudosie MS.Outcome of patients in acute poisoning with ethylene glycol--factors which may have influence on evolution[J].J Med Life,2014,7(3):81-86.
15 Singh R,Arain E,Buth A,et al.Ethylene glycol poisoning:an unusual cause of altered mental status and the lessons learned from management of the disease in the acute setting[J].Case Rep Crit Care,2016,2016:Epub 9157393.
2谭彬昕,董瑶瑶,张志坚.急性乙二醇中毒44例文献检索报告[J].海南医学,2015,26(7):1065-1067.
3 Tanasescu A,Macovei RA,Tudosie MS.Outcome of patients in acute poisoning with ethylene glycol-factors which may have influence on evolution[J].J Med life,2014,7(3):81-86.
4 Alhamad T,Blandon J,Meza AT.Acute kidney injury with oxalate deposition in a patient with a high anion gap metabolic acidosis and a normal osmolal gap[J].J Nephropathol,2013,2(2):139-143.
5朱士胜,黄伟,赵鹏,等.SD大鼠急性乙二醇中毒的法医病理学研究[J].重庆医科大学学报,2014,39(1):43-46.
6黄玉红,王轶淳,王炳元,等.酒精性肝病血清乙醇脱氢酶的变化[J].中华肝脏病杂志,2002,10(1):24.
7 Cooper CM,Baron JM.Case 4-2015.A 49-year-old man with obtundation followed by agitation and acidosis[J].N Engl J Med,2015,372(5):465-473.
8 Hopper K,Epstein SE.Falsely increased plasma lactate concentration due to ethylene glycol poisoning in 2 dogs[J].J Vet Emerg Crit Care(San Antonio),2013,23(1):63-67.
9 Riquier T,Geri G,Mongardon N,et al.False hyperlactatemia in lifethreatening ethylene glycol poisoning[J].Ann Fr Anesth Reanim,2014,33(4):79-81.
10 Schoen JC,Cain MR,Robinson JA.Adolescent presents with altered mental status and elevated anion gap after suicide attempt by ethylene glycol ingestion[J].Pediatr Emerg Care,2016,32(10):688-690.
11 Horinek EL,Kiser TH,Fish DN,et al.Propylene glycol accumulation in critically ill patients receiving continuous intravenous lorazepam infusions[J].Ann Pharmacother,2009,43(12):1964-1971.
12 Su Z,Stone RW,Zhu Y.Positive propylene glycol result in a patient with ethylene glycol poisoning[J].Clin Chem,2014,60(4):697-798.
13 T Theelen.Urine fluorescence in ethylene glycol poisoning[J].N Engl J Med,2007,356(19):2006-2007.
14 Tanasescu A,Macovei RA,Tudosie MS.Outcome of patients in acute poisoning with ethylene glycol--factors which may have influence on evolution[J].J Med Life,2014,7(3):81-86.
15 Singh R,Arain E,Buth A,et al.Ethylene glycol poisoning:an unusual cause of altered mental status and the lessons learned from management of the disease in the acute setting[J].Case Rep Crit Care,2016,2016:Epub 9157393.