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[儿童急性酒精中毒。诊断、治疗及并发症]

[Acute alcohol intoxication in children. Diagnosis, treatment and complications].

作者信息

Madsen L P

机构信息

Randers Centralsygehus, paediatrisk afdeling.

出版信息

Ugeskr Laeger. 1990 Aug 13;152(33):2362-4.

PMID:2219477
Abstract

The purpose of this review is to describe the diagnosis, emergency treatment and further observation and complications. Alcohol poisoning and complications are underdiagnosed problems. Intoxication in young children is accidental and due to lack of experience in older children. Strong spirits are usually involved. The speed of elimination is greater than in adults and presumably 3-8 mmol/l/h. Fatal cases with alcohol concentrations less than 3.0% have been reported. The lethal dose is presumably 3 g/kg. Symptoms are as in adults but appear at lower concentrations. Infants do not reach a stage of exitation. Children are more prone to develop complications such as hypothermia, acidosis, electrolyte disturbance and trauma. Hypoglycaemia develops in 24-50% of cases, more frequently in infants and after starvation. The treatment is aspiration, admission to hospital, close observation, determination of core temperature, alcohol concentration, blood glucose-concentration and determination of serum-electrolytes. Blood glucose should be monitored. Treatment is conservative but severely intoxicated children may require dialysis.

摘要

本综述的目的是描述酒精中毒的诊断、急救治疗、进一步观察及并发症情况。酒精中毒及其并发症是诊断不足的问题。幼儿酒精中毒多为意外,大龄儿童则是由于缺乏经验。通常涉及烈性酒。酒精消除速度比成人快,推测为3 - 8毫摩尔/升/小时。有报告称血液酒精浓度低于3.0%时也会出现致命病例。致死剂量推测为3克/千克。症状与成人相似,但在较低浓度时就会出现。婴儿不会进入兴奋期。儿童更易出现并发症,如体温过低、酸中毒、电解质紊乱和创伤。24% - 50%的病例会发生低血糖,婴儿及饥饿后更常见。治疗方法包括洗胃、住院、密切观察、测定核心体温、酒精浓度、血糖浓度及血清电解质。应监测血糖。治疗以保守治疗为主,但严重中毒的儿童可能需要透析。

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