CAJ | 학술논문

目的：阐述连续进食亚硝酸钠高铁血红蛋白（MetHb)累积中毒原理及临床症状特点，查明连续发生食物中毒的原因，提高诊断率、报告率、及时处置率，防止此类事件的再次发生。方法流行病学调查（个案调查、现况调查、回顾调查）、现场卫生学调查、实验室检验。结果连续进食中毒一例，好转后又将亚硝酸钠误做食盐过量食用急性中毒死亡；群体中毒58例，均痊愈。三次中毒连续发生在同一农民家中，食同一袋亚硝酸钠。检验样品20份，6份食品和4份呕吐物检出亚硝酸盐。结论农民食品安全意识差，将亚硝酸钠随意添加到饭菜进食或随意存放误食造成中毒。由于连续进食引起MetHb累积中毒罕见，临床症状不典型诊断困难，中毒不能有效控制，导致了食物中毒事件连环发生。建议采取加强培训和监管、改进包装标签、广泛开展宣传教育等综合措施，杜绝中毒事件再次发生。
목적：천술련속진식아초산납고철혈홍단백（MetHb)루적중독원리급림상증상특점，사명련속발생식물중독적원인，제고진단솔、보고솔、급시처치솔，방지차류사건적재차발생。방법류행병학조사（개안조사、현황조사、회고조사）、현장위생학조사、실험실검험。결과련속진식중독일례，호전후우장아초산납오주식염과량식용급성중독사망；군체중독58례，균전유。삼차중독련속발생재동일농민가중，식동일대아초산납。검험양품20빈，6빈식품화4빈구토물검출아초산염。결론농민식품안전의식차，장아초산납수의첨가도반채진식혹수의존방오식조성중독。유우련속진식인기MetHb루적중독한견，림상증상불전형진단곤난，중독불능유효공제，도치료식물중독사건련배발생。건의채취가강배훈화감관、개진포장표첨、엄범개전선전교육등종합조시，두절중독사건재차발생。
Objective The continuous feeding of sodium nitrite High-speed Rail hemoglobin (MetHb)accumulation poi?soning principle and clinical symptoms, find out the continuous occurrence of the cause of food poisoning, improve the diag?nosis rate, reporting rate,timely disposal rate, to prevent such incidents from happening again. Method Epidemiological investigation (case investigation, survey, retrospective su rvey), site survey, laboratory test. Result Continuous food poison?ing patients, improved after the sodium nitrite mistake do saltexcessive consumption of acute poisoning death; 58 cases of mass poisoning were cured. Three poisoning occurred in the same farmer home, eat a bag of sodium nitrite. Test 20 sam?ples, 6 samples of food and 4 vomit detection of nitrite. Conclusion The food safety consciousness difference, the sodium nitrite add to eat or be eatenfood causing poisoning. Due to the continuous accumulation of MetHb poisoningcaused by eat?ing rare atypical clinical symptoms, the diagnosis is difficult, the effective control of poisoning not, cause food poisoning oc?curred in serial. Recommended to strengthen training and supervision, improve the packaging label, to carry out extensive publicity and education and other comprehensive measures, to preventpoisoning.