Akyildiz B N, Kurtoğlu S, Kondolot M, Tunç A
Department of Pediatric Intensive Care, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Ann Trop Paediatr. 2010;30(1):39-43. doi: 10.1179/146532810X12637745451951.
To report diagnostic, clinical and therapeutic aspects of cyanide intoxication resulting from ingestion of cyanogenic glucoside-containing apricot seeds.
Thirteen patients admitted to the Pediatric Intensive Care Unit (PICU) of Erciyes University between 2005 and 2009 with cyanide intoxication associated with ingestion of apricot seeds were reviewed retrospectively.
Of the 13 patients, four were male. The mean time of onset of symptoms was 60 minutes (range 20 minutes to 3 hours). On admission, all patients underwent gastric lavage and received activated charcoal. In addition to signs of mild poisoning related to cyanide intoxication, there was severe intoxication requiring mechanical ventilation (in four cases), hypotension (in two), coma (in two) and convulsions (in one). Metabolic acidosis (lactic acidosis) was detected in nine patients and these were treated with sodium bicarbonate. Hyperglycaemia occurred in nine patients and blood glucose levels normalised spontaneously in six but three required insulin therapy for 3-6 hours. Six patients received antidote treatment: high-dose hydroxocobalamin in four and two were treated with a cyanide antidote kit in addition to high-dose hydroxocobalamin. One patient required anticonvulsive therapy. All patients recovered and were discharged from the PICU within a mean (SD, range) 3.1 (1.7, 2-6) days.
Cyanide poisoning associated with ingestion of apricot seeds is an important poison in children, many of whom require intensive care.
报告因摄入含氰苷的杏仁种子导致氰化物中毒的诊断、临床及治疗方面的情况。
回顾性分析2005年至2009年间埃尔西耶斯大学儿科重症监护病房（PICU）收治的13例因摄入杏仁种子而发生氰化物中毒的患者。
13例患者中，4例为男性。症状出现的平均时间为60分钟（范围20分钟至3小时）。入院时，所有患者均接受了洗胃并给予活性炭。除了与氰化物中毒相关的轻度中毒体征外，还有严重中毒情况，需要机械通气（4例）、低血压（2例）、昏迷（2例）和惊厥（1例）。9例患者检测到代谢性酸中毒（乳酸酸中毒），这些患者用碳酸氢钠治疗。9例患者出现高血糖，6例患者血糖水平自发恢复正常，但3例患者需要胰岛素治疗3至6小时。6例患者接受了解毒剂治疗：4例接受高剂量羟钴胺，2例除高剂量羟钴胺外还接受了氰化物解毒试剂盒治疗。1例患者需要抗惊厥治疗。所有患者均康复，平均（标准差，范围）3.1（1.7，2至6）天内从PICU出院。
与摄入杏仁种子相关的氰化物中毒是儿童中的一种重要中毒情况，许多患儿需要重症监护。
