Woman eating ravioli "bloody blue" doctor how it works-wonton-IT information
More than half a month ago, 26 years old girl Tiffany not only coma, cardiopulmonary arrest, blue in the face, the body's blood also turns blue! Tiffany is now Sir run run Shaw hospital affiliated to Zhejiang University recovered from back to this hellish experience, she still haunt.
What is wrong with Tiffany? Sir run run Shaw hospital participation Cai Huabo, Deputy Director of the rescue to a conclusion: nitrite poisoning.
"Nitrite poisoning are common symptoms of food poisoning in the summer. In addition to processed foods may lead to poisoning, but due to high temperatures in the summer, excess food due to improper storage easy increase in nitrite content in lead poisoning. Therefore, the public fresh food is a good choice. "Cai Huabo said.
Girl eating ravioli to go to work
Two hours later, dizziness, tightness in the chest
The morning of May 23, worked in Hangzhou small us up as usual, in a noodle shop eat breakfast and then go to work. But 2 hours later, she appeared dizzy and feeling of tightness in the chest, you leave home. But when he got home, more and more serious. After the shoot for her landlord sent out a distress call, she lost consciousness.
Cai Huabo admissions to Tiffany it was noon. At the emergency room door, there came a short call, a man carrying a small beautiful rushed in, the medical staff immediately surrounding it. Small beauty has been in a coma at this point, should not, blue in the face, lips cyanotic, cardiorespiratory arrest. "Our emergency doctor on duty quickly began cardiopulmonary resuscitation, endotracheal intubation, intravenous injection of adrenaline and other rescue. About 10 minutes later, Tiffany heart beat resumed. ”
Just when everyone sighed slightly, only to find that she is still very bad: 100% in the ventilator and oxygen under high pressure into the lungs, Tiffany's blood oxygen saturation is only 80%, but also in decline. This means that, even if a high concentration of pure oxygen into the lungs, she could not absorb. Blood pressure is sustained by lots of adrenaline, only 76/40mmHg, but also has a tendency to fall further.
This small beautiful face turned purple, skin a pale shade of green and is covered with spots. Even more surprising is that doctors extracted blood from within her veins turns out to be dark blue, as described in the science fiction of "bloody blue".
Exactly what ails the patient? What kind of conditions that can cause a young man suddenly cardiorespiratory arrest? Facing the doctor asked, send us to the Emergency Department of the landlord is unable to provide any information that will help patients.
Doctors judge
May be nitrite poisoning
In no get any has value information of situation Xia, Cai Huabo according to Tiffany of clinical performance and rescue process of situation has been in analysis: patients for young women, according to landlord told also no clear of serious of history, patients of oxygen and poor, and oxygen saturated degrees and blood of blood oxygen points pressure high very not match, and blood rendering blue black, this situation should consider is poisoning due to, most has may of is Asia nitrate poisoning, and for big dose of Asia nitrate poisoning.
While talking to the landlord, and then came the police (landlord see Tiffany called the police without breathing) after full discussion, Cai Huabo decided to do it for Mei detoxifying and antioxidant treatment with methylene blue. Methylene blue as slowly pushed into a blood vessel, 20 minutes later, Tiffany oxygen saturation indicator began to slowly rise, rose from 80% to 85%, 92%, meanwhile, has been steadily rising blood pressure. At this point, Mei face blue gradually receded, exposing a fair complexion. Again using methylene blue after treatment, her condition stabilized, blood oxygen saturation rose to 98%, samples of red blood will return to normal.
Because of concerns about toxic impact on the other organs of the body, Tiffany was sent to the emergency intensive care for further treatment. Lucky is that Tiffany gradually recovered, and full recovery of consciousness. By monitoring her organs function without any exception.
Doctors then asked Mei to eat anything, she recalls, just point a bowl of wontons for breakfast, "minced meat, mustard, eggs are stuffed into the skin, used to eat. ”
Long-term low-dose intake of nitrite
Can lead to esophageal cancer
Doesn't suit that will be Tiffany stuffing fresh large ravioli cause of nitrate poisoning?
Cai Huabo describes, in a variety of processed meats, nitrite as a preservative and antiseptic, like we usually eat ham, sausage, bacon, and so on. Nitrite poisoning mistake is the most common, found in excessive eating nitrite cured meats, pickles, pickle or rotten vegetables, rare cases is mistaken nitrite as salt in cooking. When intestinal disorders, and Salmonella typhimurium or Escherichia coli to restore the nitrate to nitrite poisoning. "Of course, ate the same food, may be poisoned, it was not, that is each person's Physiology or food intake has. In addition, everyone's tolerance for nitrite is also different. ”
Cai Huabo introduction, generally caused by acute nitrite poisoning symptoms include nausea, chest discomfort, shortness of breath, and most characteristic manifestations of nitrite poisoning, is the skin, mucosa of patients with special Brown, blue and Brown. In addition, with different nitrite intake, patients may also experience chest tightness, shortness of breath, difficulty breathing, severe coma, shock and even death may occur. If the long-term low-dose intake of nitrite can lead to esophageal cancer, pregnant women eat the fetus also teratogenic effects.
Special reminder
Vegetables most vulnerable to nitrate enrichment
Under natural conditions, nitric nitrogen in vegetable proteins, is itself extremely prone to nitrate enrichment. And the spread of use of nitrogen fertilizers and also increase the production of nitrates. But vegetables picked from heated cooking process, nitrite concentrations of volatility.
When the vegetables had just been harvested, nitrite are minimal. But when placed after a long time at room temperature, this synthetic protein metabolism decreases, and vegetables in vivo nitrate reductase activity, result in nitrate reduction to nitrite in vegetables. Store at room temperature, 1-3 day of nitrite can reach a peak, if it is placed in the refrigerator, be relatively better, "nitrite peaks" is deferred until 3-5 days.
Not only fresh vegetables, fresh eating, even cooked vegetables also should eat fresh, this is because the bacteria is also rich in nitrate reductase. Studies have used 20 kinds of vegetables for the day with overnight accomodation nitrite detection, finding overnight accomodation nitrite in the cooked vegetables in general higher than the cooked vegetable of the day.
How to avoid the hazards of nitrite
In everyday life, how to avoid the hazards of nitrite? Cai Huabo recommends:
Do not eat the fresh bacon, vegetables.
Leftovers can not be stored for too long at a high temperature after eating.
The day to buy fresh fruits and vegetables meat and best eaten in a meal.
Because of excreted nitrite is hard to, if you already eat, want to eat rich in vitamin c, so you can block the nitrite in the stomach produce carcinogens.
If had a barbecue stands, might as well with vegetables, fruit, vitamin c, vitamin e, antioxidant, anti-cancer supplement it.
Suspected nitrite poisoning treatment
Most characteristic manifestations of nitrite poisoning, is the skin, mucosa of patients with special Brown, blue and Brown. In addition, with different nitrite intake, patients may also experience chest tightness, shortness of breath, difficulty breathing, severe coma, shock and even death may occur.
When dining after the skin and mucosa blue to black, chest tightness, shortness of breath and other symptoms when suspected nitrite poisoning. Suspected nitrite poisoning, if symptoms are mild, patient can vomit and continued to vomit after drinking plenty of water several times. In stable conditions after timely treatment, up to doctors to decide follow-up treatment.
女子吃馄饨变“蓝血人”，医生揭秘 - 馄饨 - IT资讯
半个多月前，26岁的姑娘小美不但昏迷、面色发青、心跳呼吸骤停，体内的血竟还变成了蓝色！小美如今已从浙江大学医学院附属邵逸夫医院康复出院，可回想起这一趟鬼门关的经历，她仍心有余悸。
小美究竟怎么了？邵逸夫医院参与抢救的蔡华波副主任医师给了一个结论：亚硝酸盐中毒。
“亚硝酸盐食物中毒是夏季常见的饮食中毒病症。除了腌制食品可能导致中毒外，因夏天高温，过剩食品因贮藏不当容易出现亚硝酸盐含量增多导致中毒。因此，市民最好选择新鲜食物。”蔡华波说。
姑娘吃完馄饨去上班
两小时后头晕、胸闷
5月23日早上，在杭州工作的小美如往常一样起床，在一家面店吃完早餐后就去上班。然而2小时后，她出现了头晕、胸闷的感觉，就请假回了家。谁知到家后，情况越来越严重。在拼力向房东发出求救后，小美便失去了意识。
蔡华波接诊到小美正是中午时分。当时急诊室门外传来一阵急促的呼叫声，一个男子背着小美冲了进来，医护人员立马围了上去。此时的小美已处于昏迷状态，呼之不应，面色发青、口唇紫绀，心跳呼吸停止。“我们急诊值班医生迅速开始心肺复苏、气管插管、肾上腺素静脉推注等各项抢救。大约10分钟后，小美的心跳恢复了。”
正当大家稍稍舒了一口气时，却发现小美的情况依旧很糟糕：在呼吸机以100%氧气并以高压力送进肺里的情况下，小美的血氧饱和度还是只有80%，而且还在下降。这意味着，即使把高浓度的纯氧送进肺里，她也吸收不了。血压在大量的肾上腺素维持下，仍然只有76/40mmHg，而且还有进一步下降的趋势。
此时的小美颜面部发紫，全身皮肤也呈现淡淡的青色并布满花斑。更让人吃惊的是，医生从她血管内抽出的血竟然是蓝黑色，就好像科幻小说中描述的“蓝血人”那样。
病人到底得了什么病？是什么样的状况能导致一个年轻人突然心跳呼吸停止？面对医生的询问，送小美来急诊的房东却无法提供对病情有帮助的任何信息。
医生根据情况判断
可能是亚硝酸盐中毒
在没有获得任何有价值信息的情况下，蔡华波根据小美的临床表现和抢救过程的情况一直在分析：患者为年轻女性，据房东讲也没有明确的严重的病史，病人的氧和差、氧饱和度和血气的血氧分压高非常不匹配、血液呈现蓝黑色，这种情况应该考虑是中毒所致，最有可能的是亚硝酸盐中毒，而且为大剂量的亚硝酸盐中毒。
在跟房东以及随后赶来的警察（房东见小美没了呼吸就报了警）进行充分沟通后，蔡华波决定立即为小美做亚甲蓝解毒及抗氧化治疗。随着亚甲蓝缓缓地推入血管，20分钟后，小美的氧饱和度指标开始慢慢上升，从80%升到85%，直至92%以上，同时，血压也逐渐稳定地上升。此时，小美脸上的青色也逐渐退去，露出白皙的肤色。在再次应用亚甲蓝治疗后，她的状况逐渐稳定，血氧饱和度上升到了98%，抽取的血液也恢复正常的红色。
由于担心中毒对身体其他器官带来影响，小美被送入急诊监护病房进一步治疗。幸运的是，小美逐渐清醒过来，而且意识完全恢复。经监测，她的各器官功能没有任何异常。
医生随后询问小美吃过什么东西，小美回忆说，就早餐时点了碗大馄饨，“馅里有肉沫、榨菜、蛋皮等，以前也常吃。”
长期低剂量摄入亚硝酸盐
会引发食管癌等
那会不会是小美吃了馅不新鲜的大馄饨导致亚硝酸盐中毒呢？
蔡华波介绍，在各种加工肉制品中，亚硝酸盐作为发色剂和防腐剂存在，比如我们经常吃的火腿肠、腊肠、熏肉等。亚硝酸盐中毒以误服最为常见，多见于食用了亚硝酸盐超标的腌肉、腌菜、泡菜或变质的蔬菜，少数情况下是误将亚硝酸盐当作食盐做菜。当肠道功能紊乱时，沙门氏菌或大肠杆菌可以将硝酸盐还原为亚硝酸盐而引起中毒。“当然，吃了同一种东西，可能有人会中毒，有人就不会，这跟每个人的体质或者进食量都有关系。另外，每个人对亚硝酸盐的耐受性也不同。”
蔡华波介绍，一般亚硝酸盐所导致的急性中毒症状包括恶心、胸闷、呼吸急促等，亚硝酸盐中毒最具有特征性的表现，就是患者的皮肤、黏膜呈现特殊的褐色、蓝褐色。此外，随着亚硝酸盐摄入量的不同，患者还可能出现胸闷、呼吸急促、呼吸困难等，严重时还可能出现昏迷、休克甚至死亡。如果长期低剂量摄入亚硝酸盐会引发食管癌，孕妇食用还会对胎儿有致畸作用。
●特别提醒
蔬菜最易富集硝酸盐
在自然情况下，蔬菜利用硝态氮合成蛋白质，本身就极容易富集硝酸盐。而且目前使用氮肥越来越泛滥，也增加了硝酸盐的产生。不过蔬菜从采摘到加热煮熟，这过程中，亚硝酸盐的含量呈现波动状况。
当蔬菜刚刚被采收后，亚硝酸盐含量微乎其微。但当室温下放置长时间以后，这种合成蛋白质的代谢逐渐减弱，而蔬菜体内的硝酸还原酶活性增强，导致蔬菜中的硝酸盐还原为亚硝酸盐。在室温下储存，1-3天亚硝酸盐就能达到高峰，如果放在冰箱中，会相对好一点，“亚硝峰”会延迟至3-5天。
不但新鲜的蔬菜需要新鲜吃，连炒好的蔬菜也应该新鲜吃，这是由于细菌中也富含硝酸还原酶。有研究使用20种蔬菜进行当天与隔夜的亚硝酸盐检测，发现总体上隔夜熟蔬菜中的亚硝酸盐含量比当天熟蔬菜中的要高。
如何避免亚硝酸盐的危害
那么在日常生活中，如何避免亚硝酸盐的危害呢？蔡华波建议：
◆不要进食不新鲜的腌肉、蔬菜。
◆剩菜不可在高温下存放过长时间后食用。
◆瓜果蔬菜肉类等当天要购买新鲜的并最好在一餐中吃完。
◆由于亚硝酸盐很难排出体外，如果已经吃进去，最好同时摄入丰富的维生素C，这样可以在胃内阻断亚硝酸盐生成致癌物的过程。
◆如果吃了烧烤等路边摊，不妨搭配蔬菜、水果，把维生素C、维生素E等抗氧化、抗癌成分补充进去。
怀疑亚硝酸盐中毒如何救治
亚硝酸盐中毒最具有特征性的表现，就是患者的皮肤、黏膜呈现特殊的褐色、蓝褐色。此外，随着亚硝酸盐摄入量的不同，患者还可能出现胸闷、呼吸急促、呼吸困难等，严重时还可能出现昏迷、休克甚至死亡。
当用餐后出现皮肤黏膜变蓝变黑、胸闷、呼吸急促等症状时，就要怀疑到亚硝酸盐中毒。一旦怀疑亚硝酸盐中毒，如果症状轻微，患者可以催吐并饮用大量清水后继续催吐，反复多次。情况稳定后应及时就诊，由医生决定后续治疗方案。