hemodialysis fish gall bladder poisoning caused by multiple organ damage one cases（血液透析鱼胆囊中毒引起的多器官损伤病例）.docVIP

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2017-09-06 发布于浙江
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hemodialysis fish gall bladder poisoning caused by multiple organ damage one cases（血液透析鱼胆囊中毒引起的多器官损伤病例）.doc

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hemodialysis fish gall bladder poisoning caused by multiple organ damage one cases（血液透析鱼胆囊中毒引起的多器官损伤病例）

Hemodialysis fish gall bladder poisoning caused by multiple organ damage one cases [Keywords:] blood [Keywords:] hemodialysis, fish bile poisoning, multiple organ damage Containing fish bile acid, histamine, cyprinol sodium carbonate grease and cyanide and other biological toxins, food poisoning can cause multiple organ damage, acute renal failure, 1 cases of successful treatment are hemodialysis . 1 clinical data Male patients, aged 57, about 30 ml, workers, food of grass carp bile, nausea, vomiting, abdominal pain, diarrhea, outside the hospital gastric lavage 2 h after infusion, anti-inflammatory treatment of 2 d is invalid, urine output reduced to 100 ml / d the following from hospital emergency. Blood the WBC 16.2 ?109 / L, and N 0.89, L, 0.11, urine specific gravity 1.025, protein = 300 mg / dl, and granular casts + blood the ALT 2315 U / L, and of AST 1876 U / L, total bilirubin 68.8 μmol / L, direct bilirubin 33.5 μmo1 / L, indirect bilirubin 35.3 μmol / L, and LDH 581 U / L, and _AT_ - HBDH in U-535 / L, and Cr 717 μmol / L, BUN and 21.4 mmol / L CO2 - CP 18 mmol / L. kidney B super: full swollen kidneys, cortical echo, increased renal vascular resistance index. ECG showed: sinus rhythm, cardiac damage, diagnosed as acute fish gall bladder poisoning, acute renal failure , toxic hepatitis, myocarditis Kyuko right internal jugular vein catheterization, an area of #8203;#8203;1.3 m2 blood imitation membrane dialyzer bicarbonate dialysis, the time increase for the first time for 3 h to 4.5 h each time, three times a week, for a total dialysis 15, supplemented with dexamethasone, vitamin C, ceftriaxone sodium and other hepatoprotective, anti-infective, nutritional myocardial and symptomatic treatment. 3 weeks into the polyuria phase, liver function, cardiac enzymes returned to normal 12 times after dialysis BUN and 14.8 mmol / L and Cr 271 μmol / L, and to stop dialysis, continue rehydration, symptomatic treatment, discharged from hospital were