Meggs W J, Gerr F, Aly M H, Kierena T, Roberts D L, Shih R, Kim H C, Hoffman R
New York City Poison Control Center, NY 10016.
J Toxicol Clin Toxicol. 1994;32(4):377-85. doi: 10.3109/15563659409011038.
Lead poisoning is an unusual complication of gunshot wounds that occurs when retained lead bullet fragments are in contact with body fluids capable of solubilizing lead. The epidemic of violence by gunfire may result in increasing numbers of lead poisoning cases from this exposure. The use of oral chelation for toxicity resulting from this mode of exposure has not been previously discussed. Cases of lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest, and pleural space are reported. A combination of surgical debridement and chelation therapy with oral succimer produced a satisfactory outcome in all three cases. Oral succimer may be a safe and effective chelation agent for treating lead toxicity in adults with high lead levels secondary to gun shot wounds.
铅中毒是枪伤的一种罕见并发症，当残留的铅弹碎片与能够溶解铅的体液接触时就会发生。枪击暴力的流行可能导致因这种暴露而引发的铅中毒病例增多。此前尚未讨论过使用口服螯合剂治疗这种暴露方式导致的中毒情况。本文报告了因髋部滑膜腔、胸部滑膜腔和胸腔内的子弹铅导致铅中毒的病例。在所有三例病例中，手术清创与口服二巯基丁二酸螯合疗法相结合产生了令人满意的结果。口服二巯基丁二酸可能是治疗因枪伤导致血铅水平升高的成人铅中毒的一种安全有效的螯合剂。
