Wang Jieru, Kan Baotian, Jian Xiangdong, Wu Xiaopeng, Yu Guancai, Sun Jing
Department of Poisoning and Occupational Diseases, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China.
Department of Vascular Surgery, Qilu Hospital, Shandong University, Jinan, Shandong 250012, P.R. China.
Exp Ther Med. 2016 Jan;11(1):208-212. doi: 10.3892/etm.2015.2874. Epub 2015 Nov 17.
This study reports the case of a 44-year-old woman with oral oxalic acid poisoning. As the illness progressed, the patient exhibited severe metabolic acidosis, large-area esophageal mucosa injury and acute kidney injury, which required dialysis. A guide wire slipped out of position during the process of hemodialysis and moved back and forth in the veins, but was removed successfully by interventional endovascular treatment. However, the patient's esophageal mucosa exfoliated, which lead to severe benign esophageal stenosis and dysphagia. Balloon distention was conducted twice in the upper digestive tract using X-ray location in combination with a dumb-bell bladder and interventional wire. The patient exhibited convulsions, shock, embolism and loss of consciousness while undergoing the second balloon distention procedure. Following symptomatic treatment, the patient eventually remained in a stable condition, the digestive tract expansion procedure was not resumed and a jejunostomy was performed in order to facilitate enteral nutrition, which was administered via the jejunum and had little stimulatory effect on the pancreas. Following various treatments, the patient's condition improved markedly, with renal function returning to normal.
本研究报告了一例44岁口服草酸中毒的女性病例。随着病情进展,患者出现严重代谢性酸中毒、大面积食管黏膜损伤及急性肾损伤,需要进行透析治疗。在血液透析过程中,一根导丝移位并在静脉内来回移动,但通过血管内介入治疗成功取出。然而,患者食管黏膜脱落,导致严重的良性食管狭窄和吞咽困难。采用X线定位结合哑铃形球囊及介入导丝在上消化道进行了两次球囊扩张术。在第二次球囊扩张术过程中,患者出现惊厥、休克、栓塞及意识丧失。经过对症治疗,患者最终病情稳定,未再继续进行消化道扩张术,并进行了空肠造口术以方便肠内营养,营养物质通过空肠给予,对胰腺刺激较小。经过各种治疗,患者病情明显改善,肾功能恢复正常。