Sau 15 ca ngộ độc do ăn pate Minh Chay nhập viện thiếu thuốc điều trị đặc hiệu, Bộ Y tế ban hành Hướng dẫn tạm thời chẩn đoán, điều trị ngộ độc botulinum do ăn uống, áp dụng ở tất cả cơ sở khám chữa bệnh around the country.
According to the Ministry of Health, botulinum poisoning is a severe poisoning, a high death rate, and prolonged paralysis. The average time for mechanical ventilation is about two months before it can be stopped, but patients need several months to recover.
54-year-old man, living in Vung Tau, botulinum poisoning, being treated at Cho Ray Hospital has a severe prognosis, has to be ventilated for several months. Ảnh: Bệnh viện cung cấp.
People with obvious symptoms of intoxication (muscle weakness, paralysis) must be hospitalized immediately. In case of mild symptoms (fatigue, weakness), and then progressively worsen or eat suspected poisoning foods within 8 days, also need hospital monitoring. Patients with mild, in remission or asymptomatic, will be prescribed activated charcoal and laxatives to treat at home.
Patients have complications that must be closely monitored by a doctor, especially when the muscles and breathing are paralyzed. Respiratory failure patients may require prolonged mechanical ventilation.
Patients with botulinum poisoning take an antidote as soon as possible. It is best before symptoms get worse, or at any stage while the condition is severe. In theory, the drug works only with toxins that are still free, not with toxins attached to the nerve. It is therefore not possible to immediately reverse the already occurring paralysis symptoms. However, drugs can prevent poisoning from worsening and significantly shorten poisoning time, reduce the time of mechanical ventilation, resuscitation, and hospital stay.
Vietnam recorded more than 35 cases of hospital examination, 15 serious patients had to be actively treated after eating Minh Chay pate contaminated with botulinum toxin. Patients nặng điều trị tại nhiều bệnh viện. Each hospital treated according to different regimen.
Couple of patients are being treated at the Poison Control Center, Bach Mai Hospital, the first case of using an antitoxin serum, on August 29. Doctor Nguyen Trung Nguyen, director of the Center, said that after 10 days of taking the medicine, the wife had improved significantly, sitting, walking, taking care of herself, speaking clearly, eating by mouth. The husband improved but more slowly due to eating more pate Minh Chay, more poisoning.
Patients nặng khác điều trị tại TP HCM không có thuốc giải độc đặc hiệu, vẫn phải thở máy. Dr. Le Quoc Hung, Head of the Department of Tropical Diseases, Cho Ray Hospital, said that over 30 years of working, he has never encountered any botulinum poisoning. Therefore, it can only be found in the literature. Approaching the patient initially, he and his colleagues misdiagnosed. They took a lot of time, carried out a series of intensive tests, coordinated with the Institute of Hygiene and Epidemiology to accurately determine the botulinum toxin generated from the bacterium Clostridium botulinum as the causative agent.
When the toxin is not resistant, the only way is to wait for the poisoned nerve cells to age, die, flush out the toxin and regenerate new healthy cells. Depending on the status and degree of poisoning of each person, the cell regeneration period is from one to three months. At this stage, the doctor applies a series of non-specific treatments, including mechanical ventilation, dialysis, plasma exchange, vitamin B supplementation, nutritional enhancement, physical therapy ... prolonging the life for the patient.