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甲醇中毒:典型毒性及后果的一种表现

Methyl alcohol poisoning: a manifestation of typical toxicity and outcome.

作者信息

Nand Laxmi, Chander Subhash, Kashyap Rajesh, Gupta Dalip, Jhobta Anupam

出版信息

J Assoc Physicians India. 2014 Aug;62(8):756-9.

Abstract

Methyl alcohol poisoning is an uncommon but an extremely hazardous poisoning. It most commonly occurs via oral ingestion of illicit or adulterated liquors or as ethanol substitution. The clinical diagnosis is made in the presence of high index of suspicion of toxic alcohol ingestion, early visual symptoms, unexplained anion gap metabolic acidosis and significant osmolar gap. Rapid recognisation, early and aggressive management have been emphasized to prevent hazardous outcome. We report a case of methyl alcohol poisoning manifestation of typical toxicity and outcome which revealed severe metabolic acidosis with high anion gap, blindness complicating bilateral optic atrophy and putaminal hemorrhagic necrosis. The patient improved with aggressive treatment including oral ethyl alcohol, but the occurrence of permanent blindness could not be prevented probably due to late presentation.

摘要

甲醇中毒是一种罕见但极其危险的中毒情况。它最常见于口服非法或掺假酒类,或作为乙醇替代品摄入。临床诊断基于对有毒酒精摄入的高度怀疑指数、早期视觉症状、无法解释的阴离子间隙代谢性酸中毒以及显著的渗透压间隙。强调快速识别、早期积极治疗以预防不良后果。我们报告一例甲醇中毒病例,其表现出典型的毒性和后果,包括高阴离子间隙的严重代谢性酸中毒、双侧视神经萎缩并发失明以及壳核出血性坏死。患者通过包括口服乙醇在内的积极治疗有所改善,但由于就诊较晚,可能无法预防永久性失明的发生。

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