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重度溴甲烷中毒致早期急性肾衰竭和无尿:一例报告。

Severe methyl bromide poisoning causing early acute renal failure and anuria: a case report.

机构信息

Department of Poisoning and Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.

School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China.

出版信息

J Int Med Res. 2022 Oct;50(10):3000605221122619. doi: 10.1177/03000605221122619.

Abstract

Methyl bromide is a pre-plant soil fumigant that is widely used to control nematodes, insects, and fungi in farmlands. Methyl bromide enters the human body through dermal absorption or inhalation and can damage the respiratory, nervous, circulatory, urinary, and other systems. A 62-year-old man who had inhaled a large amount of methyl bromide was admitted to our department. He presented with respiratory failure and pink foamy sputum. He was started on dexamethasone, alanyl glutamine, sulbactam, furosemide, vitamin B, mouse nerve growth factor, and other treatments, and mechanical ventilation and continuous venovenous hemodiafiltration (CVVHF) were performed daily. He subsequently developed coagulopathy because of the CVVHF, for which protamine, recombinant human brain natriuretic peptide, and albumin were administered intravenously. Notably, the patient developed sustained anuria and eventually died owing to multiple organ failure; specifically, failure of the brain, heart, lungs, and kidneys. This report presents the diagnosis, clinical course, management, and prognosis of a patient who was treated at our hospital for severe methyl bromide poisoning.

摘要

甲基溴是一种预植土壤熏蒸剂,广泛用于控制农田中的线虫、昆虫和真菌。甲基溴通过皮肤吸收或吸入进入人体,可损害呼吸、神经、循环、泌尿等系统。一名 62 岁男子因吸入大量甲基溴而被收入我科。他表现为呼吸衰竭和粉红色泡沫痰。给予地塞米松、丙氨酰谷氨酰胺、舒巴坦、呋塞米、维生素 B、鼠神经生长因子等治疗,并每日进行机械通气和连续静脉-静脉血液透析滤过(CVVHF)。随后,由于 CVVHF 出现凝血功能障碍,给予了静脉注射鱼精蛋白、重组人脑利钠肽和白蛋白。值得注意的是,患者出现持续无尿,最终因多器官功能衰竭而死亡;具体来说,脑、心、肺和肾功能衰竭。本报告介绍了一名在我院治疗重度甲基溴中毒患者的诊断、临床过程、治疗和预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5faa/9578171/a2a9daf56acd/10.1177_03000605221122619-fig1.jpg

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