体外膜氧合综合治疗急性重度氨气中毒1例
One case of comprehensive treatment of acute severe ammonia-induced intoxication with extracorpo-real membrane oxygenation
邵义如 1何岱昆 1金恋欢 1敦宇 1申捷1
作者信息
- 1. 复旦大学附属金山医院急危重病中心,复旦大学化学伤害急危重病医学研究中心,上海市卫生健康委化学伤害急危重病医学重点实验室,上海 201508
- 折叠
摘要
急性氨气中毒属于急性刺激性气体中毒,主要通过直接和间接肺损伤引起全身炎症反应及免疫功能紊乱,导致化学源性肺水肿、急性呼吸窘迫综合征(ARDS)等发生.其中毒损伤机制复杂,一旦发生ARDS,患者病死率明显上升.本文患者急性重度氨气中毒,通过体外膜氧合(ECMO)联合支气管镜等重症技术应用,取得良好效果,得到成功救治.本文通过分析重度氨气中毒合并ARDS患者的诊治过程,总结氨气中毒损伤的临床特点、ECMO及各项重症医学技术的应用时机,以利于临床上针对时机进行氨气中毒的高效干预治疗,提高患者生存率.
Abstract
Acute ammonia-induced intoxication is a kind of acute irritant gas poisoning,which mainly causes systemic inflammatory reaction and immune dysfunction through direct and indirect lung injury,leading to chemogenic pulmonary edema and acute respiratory distress syndrome(ARDS).The mechanism of its toxic injury is complex,and the fatality rate of patients increases significantly once ARDS occurs.In this paper,the patient with acute and severe ammonia-induced intoxication was successfully treated by extracorporeal membrane oxygenation(ECMO)combined with fiberoptic bronchoscopy and other critical technologies,and achieved good results.By analyzing the diagnosis and treatment process of severe ammonia-induced intoxication complicated with ARDS patients,this paper summarizes the clinical characteristics of ammonia-induced intoxication injury,and the application opportunities of ECMO and various critical medical technologies,so as to facilitate the efficient intervention and treatment of ammonia-induced intoxication according to the clinical opportunity and improve the survival rate of patients.
关键词
气体中毒/氨气中毒/急性呼吸窘迫综合征/体外膜氧合/病例报告Key words
Gas poisoning/Ammonia-induced intoxication/Acute respiratory distress syndrome,ARDS/Extracorporeal membrane oxygenation,ECMO/Case report引用本文复制引用
基金项目
国家自然科学基金青年项目(82002027)
出版年
2024
NETL
NSTL
万方数据