Laurent Yves, Wallemacq Pierre, Haufroid Vincent, Renkin Jean, Liolios Antonios, Hantson Philippe
Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium.
J Emerg Med. 2006 Feb;30(2):179-82. doi: 10.1016/j.jemermed.2005.05.019.
We report a case of deliberate ingestion of 12.5 g chloral hydrate in a 25-year-old psychiatric patient. Coma and life-threatening ventricular dysrhythmias were observed soon after ingestion. Repeated electrocardiographic examination was consistent with ischemic changes appearing on day 3. They were associated with segmental abnormal left ventricular wall motion by echocardiography. A coronary angiogram was performed and was normal. Toxic metabolites of chloral hydrate, trichloroethanol and trichloroacetic acid were found in the urine until day 7. This case illustrates that with halogenated aliphatic hydrocarbons, sustained changes in cardiac contractility may occur in addition to early life-threatening ventricular dysrhythmias.
我们报告一例25岁精神科患者故意摄入12.5克水合氯醛的病例。摄入后不久即观察到昏迷和危及生命的室性心律失常。重复心电图检查与第3天出现的缺血性改变一致。超声心动图显示这些改变与节段性左心室壁运动异常有关。冠状动脉造影正常。直到第7天，尿液中仍可检测到水合氯醛的有毒代谢产物三氯乙醇和三氯乙酸。该病例表明，对于卤代脂肪烃，除了早期危及生命的室性心律失常外，还可能出现心脏收缩力的持续改变。
