聚乙醛農藥中毒之臨床經驗毒藥物諮詢中心電話諮詢個案之分析

Clinical Experience in Metaldehyde Intoxication: An Analysis of Telephone Inquiries Made to Poison Control Center

翁惠生(Hoe-Seng Ueng) ； 林增記(Tzeng-Jih Lin) ； 楊振昌(Chen-Chang Yang) ； 鄧昭芳(Jou-Fang Deng)

《中華民國急救加護醫學會雜誌》 6卷2期 (1995/06) Pp. 60-66

https://doi.org/10.30018/JECCM.199506.0003

摘要

聚乙酸(Metaldehyde)是種低毒性的乙酸(Acetaldehyde)之四聚或六聚化合物，目前在臺灣被廣泛地使用於誘殺蝸牛上。此物質一般被製作成餌劑（粒劑）及可濕性粉劑兩種劑型，而在歐洲，也常被用來製成燃料。常見的中毒途徑包括誤食、蓄意服食自殺、吸入或皮膚接觸等。大多數的中毒病例在適當處置之後，都能完全復原；但過去也曾有因中毒而死亡的病例被發表過。我們在此以回溯性的方式研究由榮總臨床毒藥物諮詢中心(PCC)，自民國八十年迄八十三年間收集到的十二個電話諮詢個案（包括一個死亡案例在內），並且針對這些個案的性別、年齡、中毒原因及途徑、劑量、症狀、徵候、嚴重度，以及自中毒迄就醫所花費的時間，加以分析及討論。我們發現：雖然多數的患者為無症狀或屬於輕度中毒，但患者若同時有喝酒，則中毒的臨床表現會比較嚴重，甚至因而致死。因此提醒在急診室工作的醫護同仁，勿輕忽聚乙醛的毒性，特別要積極監測那些同時有喝酒的患者，因為即使他們初到急診時情況穩定，仍有臨床過程急速惡化甚至死亡的可能性。

關鍵字

聚乙醛 ； 驚厥發作 ； 酒精

並列摘要

Metaldehyde, a solid tetramer of acetaldehyde with low toxicity, has been widely available in commercial molluscicide preparations. In Taiwan, the formulations are limited to tablets and wetting powders; while in Europe, the uses for metaldehyde include Meta-fuel tablets. Common routes of exposure include accidental ingestion, suicidal ingestion, inhalation, and dermal contact. Most intoxicated cases recovered completely after supportive management, however, there were some fatalities reported.
We underwent a retrospective study which covered a period of four years beginning from 1991 through 1994. During this time, twelve cases with a history of exposure to metaldehyde and reported to the Poison Control Center-Taiwan were included, and the clinical data such as sex, age, cause and route of exposure, dose, symptoms, signs, severity, and duration between exposure and first aid in the hospital were analyzed. We found that most of the patients were asymptomatic or only mildly intoxicated; but if alcohol was consumed in the meantime, the clinical couse could be worsened and mortality was thus likely. Therefore, physicians who are working in the emergency room should be aware of the potential toxicity of metaldehyde-even though the patients may look stable initially, the clinical condition can deteriorate rapidly, especially if alcohol has been co-ingested.

並列關鍵字

Metaldehyde ； seizure ； alcohol