重度氨中毒伴心肌损伤1例报告

A Case Report of Severe Ammonia Poisoning with Myocardial Damage

  • 摘要: 患者男性, 26岁,因液氨钢瓶爆裂, 吸入氨气中毒昏迷。胸部X线片示:两肺见散在片状模糊阴影;心酶谱检查结果显示:乳酸脱氢酶1 193 U/L、肌酸激酶1 408 U/L, 肌酸激酶同工酶CK-MB 62 U/L, 提示出现中毒性心肌损伤。经对症处理、维持气道通畅、纤维支气管镜肺灌洗等治疗后, 患者痊愈出院, 经随访无后遗症。提示, 应当及早预防氨中毒, 一旦发生氨中毒, 则应及时予以检查, 对症救治, 谨防心肌损伤。

     

    Abstract: A male worker, 26 years old, was reported coma with ammonia inhalation due to explosion of a liquid ammonia steel canister. The chest X-ray images revealed scattered patchy shadows in both lungs. The significantly higher levels of lactate dehydrogenase(1 193 U/L), creatine kinase(1 408 U/L), and creatine kinase isoenzyme CK-MB(62 U/L)indicated toxic myocardial damage. After treated with mechanical ventilation and lung lavage by bronchoscopy, the patient was recovered and discharged. No further symptom or sign was found in the follow-up visit. It is imperative that employers and employees should take appropriate measures to prevent ammonia intoxication in good time and receive promptly treatment to prevent myocardial damage.

     

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