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急性秋水仙碱中毒死亡伴心搏骤停1例并文献复习
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Abstract:
背景：急性秋水仙碱中毒是临床工作中极为罕见的危急重症，其死亡率高达14.3%~25.6%。目的：提高临床医师对急性秋水仙碱中毒导致心搏骤停和循环衰竭的早期识别、发生机制、临床表现及治疗措施的认识。方法：本研究回顾性分析了我院收治的一例急性秋水仙碱中毒患者，该患者因并发心搏骤停和循环衰竭而死亡，并复习了相关文献。结果：经过一系列治疗措施，包括灌肠、连续肾脏替代疗法(Continuous Renal Replacement Therapy, CRRT)、血浆置换、补液、纠正电解质紊乱、血管活性药物、气管插管呼吸机辅助通气、连续胸外按压等，患者最终仍然死亡。结论：大剂量急性秋水仙碱中毒可直接损伤心肌细胞，在服毒后24小时内出现难以逆转的心搏骤停，临床医师应高度警惕这一情况，并在早期积极对症处理。
Background: Acute colchicine poisoning is an extremely rare and critical condition in clinical prac-tice, with a mortality rate ranging from 14.3% to 25.6%. Objective: To enhance clinicians’ under-standing of early recognition, mechanisms, clinical manifestations, and treatment measures for acute colchicine poisoning leading to cardiac arrest and circulatory failure. Methods: This study retrospectively analyzed a case of acute colchicine poisoning admitted to our hospital, in which the patient died due to concomitant cardiac arrest and circulatory failure. Relevant literature was also reviewed. Results: Despite a series of treatment measures, including gastric lavage, continuous re-nal replacement therapy (CRRT), plasma exchange, fluid resuscitation, correction of electrolyte disturbances, vasoactive drugs, endotracheal intubation with mechanical ventilation, and continu-ous chest compressions, the patient ultimately succumbed. Conclusion: High-dose acute colchicine poisoning can directly damage myocardial cells, resulting in irreversible cardiac arrest within 24 hours after ingestion. Clinicians should be highly vigilant about this condition and actively provide appropriate treatment in the early stages.
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