- 期刊
氰化物中毒之二病例報告
Two Reported Cases of Cyanide Intoxication
摘要
氰化物是一種反應極快的毒物，它被廣泛地使用於工業上及家庭中，並存於自然界。民國67午11月24日，高雄大社石油化學工業區，因氰化物外洩，而發生集體中毒事件，其中兩例病情嚴重小孩，送至本院。此兩例均有嘔吐、意識喪失、發紺、呼吸急促的現象，經由急救處置和解毒劑的投與，兩病例皆完全康復。過去氰化物中毒之病例雖是罕見，但因工業之發展，將來可能發生的機會較多，故提出報告及介紹氰化物中毒之處置，以供參考。
關鍵字
無資料並列摘要
Cyanides are used widely in industries and families. It can be found in some natural plants. Poisoning may be occurred by ways of ingestion, inhalation, prolonged local contact as well as enema of cyanide-containing substance. The incidence of cyanide intoxication may be increased in the future in Taiwan, especially in the Petro-Chemical Industrial Zone such as Ta She, Petro-Chemical Industrial Zone in Kaohsiung area. An Accidental poisoning due to leakage of wastewater containing cyanide at Ta-She Petro-Chemical Industrial Zone happened on November 24,1978. There were about 500 more victims. Only two among the victims were sent to the ped. department of Kaohsiung Medical College Hospital. According to the industrial zone technicians' descriptions, we knew they were cyanide intoxication cases. Through emergency management, including the supply of 100% oxygen, setting IV route, and antidotes administration: inhalation of Amyl Nitrite and parenteral supply of Sodium Nitrite and Sodium Thiosulfate, they recovered completely. Follow-up examinations of liver function, urine, and EEG in 7 months and 1 year later revealed normal data. Clinically, the odor of bitter almond oil on the breath of patient is highly suggestive of cyanide poisoning, but absence of it doesn't rule out that possibility. Other signs, which are not specific or pathognomonic, include rapid respiration that became slow and gasping later, vomiting and including followed by coma and pinkish cyanosis. Both cases had vomiting, loss of consciousness, tachypnea, and bluish cyanosis, but not pink color. Although the families of both cases denied they could smell the bitter almond odor in that morning, it could be proved cyanide intoxication by the finding of CN ion in the blood of the only dead patient and some expired dogs and cats in this accidental event. The therapeutic endeavors include: 1. Supportive treatment: Supply 100% oxygen, keeping air way open, maintaining respiratory and cardiac function etc. 2. Antidotes administration: Amyl Nitrite, Sodium Nitrite, Sodium Thiosulfate; Cobalt salt, including edetate; Hydroxocobalamin etc.