摘要
草酸二甲酯是职业性有毒化学物质之一,肾毒性较强.2023年5月16日定西市人民医院收治1例急性草酸二甲酯中毒病例,患者表现为恶心、呕吐、腰胀、乏力、纳差、无尿,并出现快速进展的急性肾损伤.肾穿刺活检证实为急性草酸盐肾病.经血液净化、抗氧化应激、糖皮质激素、补液、碱化尿液、抗感染、控制血压、补钙、纠正贫血等对症支持治疗后,患者症状消失,肾功能基本恢复正常.该病例提示,临床发现急性肾损伤患者,必须明确病因,肾穿刺活检是重要的检查手段.对于急性草酸二甲酯中毒患者,应尽早行以血液净化为主的综合救治,以改善患者预后.
Abstract
Dimethyl oxalate is one of the occupational toxic chemicals and causes strong renal toxicity.On May 16,2023,a patient with acute dimethyl oxalate poisoning was admitted to Dingxi People's Hospital.The patient presented with nausea,vomiting,lumbar distension,weakness,poor appetite,anuria,and rapidly progressing acute kidney injury.Renal biopsy confirmed acute oxalate nephropathy.After symptomatic supportive treatments such as blood purification,anti-oxidative stress,glucocorticoid,fluid supplementation,alkalized urine,anti-infection,controlling blood pressure,calcium supplementation and anemia correction,the patient's symptoms disappeared,and the kidney function basically returned to normal.This case suggested that the etiology of patients with acute kidney injury must be clearly identified,and renal biopsy was an important examination method.For patients suffering from acute dimethyl oxalate poisoning,comprehensive treatment based on blood purification should be performed as soon as possible,aiming to improve the prognosis.
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