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病例报告:乙蒜素中毒导致上消化道出血和多器官损伤。

Case Report: Upper gastrointestinal bleeding and multiorgan injury caused by ethylicin poisoning.

作者信息

Hu Wensi, Li Tongyao, Du Yu, Yang Mingyang, Liu Si, He Songbai, Long Qian, Fan Xing, Zhou Zinan, Li Xiaoyuan, Liu Junzhao

机构信息

Department of Critical Care and Emergency Medicine, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.

Health Emergency Management Research Center, West China School of Public Health and West China Fourth Hospital, China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Pharmacol. 2024 Dec 10;15:1472733. doi: 10.3389/fphar.2024.1472733. eCollection 2024.

Abstract

Ethylicin is a pesticide with excellent bactericidal ability. The incidence of poisoning has increased in recent years with the widespread use of ethylicin in green agriculture, but reports are lacking. In this study, we described three cases of oral ethylicin poisoning. Patients developed severe upper gastrointestinal bleeding after oral administration of ethylicin. Gastroscopy showed extensive mucosal erosions and ulcerations in the esophagus, stomach, and duodenum. Impaired consciousness, multiorgan injury, irreversible shock, and cardiac arrest were observed in cases where larger doses of ethylicin were ingested. Patients were treated with comprehensive therapeutic measures, including total gastrointestinal decontamination, medications such as proton pump inhibitors and somatostatin to reduce gastric bleeding. Endoscopic hemostasis was performed when pharmacologic hemostasis was not effective. Parenteral nutritional support and organ function support were given. In patients' follow up, esophageal stenosis and dysphagia during feeding was noted, which severely affected the quality of life. Ethylicin poisoning has been a public health problem and the awareness should be raised.

摘要

乙蒜素是一种具有出色杀菌能力的农药。近年来,随着乙蒜素在绿色农业中的广泛使用,中毒发生率有所上升,但相关报道较少。在本研究中,我们描述了3例口服乙蒜素中毒病例。患者口服乙蒜素后出现严重的上消化道出血。胃镜检查显示食管、胃和十二指肠广泛的黏膜糜烂和溃疡。摄入较大剂量乙蒜素的病例出现意识障碍、多器官损伤、不可逆休克和心脏骤停。患者接受了综合治疗措施,包括全胃肠道去污、使用质子泵抑制剂和生长抑素等药物以减少胃出血。当药物止血无效时进行内镜止血。给予肠外营养支持和器官功能支持。在患者随访中,发现存在食管狭窄和进食时吞咽困难,严重影响生活质量。乙蒜素中毒已成为一个公共卫生问题,应提高认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a9f/11666350/2abefe2a96a9/fphar-15-1472733-g001.jpg

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