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马桑中毒较少见,中毒后如不正确及时的治疗,易导致死亡。我科自1993年以来共收治21例马桑中毒患者,其中20例治愈,1例死亡。为此,总结其临床特点,对及早正确诊断及治疗,降低病死率有重要意义。1 临床资料1.1 一般资料本组 21例,男性 13例,女性 8例,年龄 4～15岁,其中4～8岁15例,9～15岁6例。轻度中毒8例,重度中毒13例。发病至就诊时间最短1小时,最长3天。临床表现:轻度中毒病人可出现流涎、恶心、呕吐、头晕、胸闷。少数病人有全身瘙痒、四肢痉挛性疼痛、灼热感、心动过缓、血压升高、瞳孔缩小、呼吸增快、腱反射增强、烦燥不安。重度中毒者除上述症状外,可突然晕倒,出现阵发性惊厥。每次惊厥前常有烦燥不安、双手抓胸之先兆,继而尖叫后出现强直性惊厥、呼吸暂停、紫绀,持续3～5分钟至30分钟,随后惊厥停止而昏睡。亦有部分病人于惊厥之间歇期呈半清醒状态。一般于惊厥停止后意识逐渐清醒。严重者可出现呼吸停止,甚至心跳骤停。
Ma Sang poisoning is less common, poisoning if not correct and timely treatment, easily lead to death. Our department since 1993 treated a total of 21 cases of patients with Marians poisoning, of which 20 cases were cured, 1 case of death. To this end, summing up its clinical features, early correct diagnosis and treatment, reduce mortality is of great significance. 1 Clinical data 1.1 General Information The group of 21 cases, 13 males and 8 females, aged 4 to 15 years, of which 4 to 8 years old in 15 cases, 9 to 15 years old in 6 cases. Mild poisoning in 8 cases, severe poisoning in 13 cases. The onset of treatment to the shortest 1 hour, up to 3 days. Clinical manifestations: mild poisoning patients may appear salivation, nausea, vomiting, dizziness, chest tightness. A small number of patients have systemic itching, extremity spasmodic pain, burning sensation, bradycardia, elevated blood pressure, miosis, rapid breathing, enhanced tendon reflexes, irritability. Severe poisoning in addition to the above symptoms, can suddenly fainted, paroxysmal convulsion. Before each convulsion, often irritable, hands grasp the heart of the chest, followed by screaming tonic convulsions, apnea, cyanosis for 3 to 5 minutes to 30 minutes, followed by convulsions and lethargy stopped. There are some patients in the intermittent seizures half awake state. General awareness of consciousness gradually stopped after the convulsions stopped. Severe respiratory failure may occur, or even cardiac arrest.