甲醇与乙二醇中毒.docxVIP

甲醇与乙二醇中毒/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsAuthors/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsMarco L A Sivilotti, MD, MSc, FRCPC, FACEP, FACMT/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsJames F Winchester, MD/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsSection Editors/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsStephen J Traub, MD/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsMichele M Burns, MD, MPH/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsDeputy Editor/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributorsJonathan Grayzel, MD, FAAEM/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributors翻译/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributors王威, 副主任医师/contents/zh-Hans/methanol-and-ethylene-glycol-poisoning/contributor-disclosureContributor disclosures我们的所有专题都会依据新发表的证据和/%E7%BC%96%E8%BE%91%E5%8E%9F%E5%88%99同行评议过程而更新。文献评审有效期至：?2016-07 .?|?专题最后更新日期：?2015-09-21.There is a newer version of this topic available in?/contents/methanol-and-ethylene-glycol-poisoning?source=Out+of+date+-+zh-Hanssearch=%E4%B9%99%E4%BA%8C%E9%86%87selectedTitle=3%7E26English.该主题有一个新的?/contents/methanol-and-ethylene-glycol-poisoning?source=Out+of+date+-+zh-Hanssearch=%E4%B9%99%E4%BA%8C%E9%86%87selectedTitle=3%7E26英文版本。引言?—?美国每年都会发生几十起甲醇和乙二醇引起的致命性中毒事件，即使这两种醇的摄入量较少也可引起显著毒性。迅速诊断和及早期治疗至关重要，包括使用醇脱氢酶(alcohol dehydrogenase, ADH)进行抑制。表中总结了有助于紧急处理的事项(/contents/zh-Hans/image?imageKey=EM%2F66916topicKey=EM%2F336rank=3%7E26source=see_linksearch=%E4%B9%99%E4%BA%8C%E9%86%87表 1)。汽车防冻剂和除冰剂、挡风玻璃清洗液、溶剂、清洁剂、燃料以及其他工业品中通常含有高浓度甲醇和乙二醇。大多数严重中毒都由经口摄入引起，吸入及皮肤暴露极少引起中毒。患者可能因为寻求乙醇替代品、自残或意外(有时是因为盛装毒物的并非原容器)而摄入有毒的醇。非法蒸馏(“非法酿酒”)或偷偷用甲醇替换乙醇可引起多人甲醇中毒。为了进行适当的处理，医生必须了解这些醇类代谢活化为有毒酸性产物的方式、现有实验室检查的局限性以及解毒剂治疗(联合或不联合血液透析)的适应证。甲醇和乙二醇中毒的诊断及处理总结在此。异丙醇中毒问题以及成人和儿童中毒的一般诊疗方法将单独讨论。 (参见/contents/zh-Hans/isopropyl-alcohol-poiso