贵刊1995年24期刊出路氏《水煎服阿片壳中毒致呼吸衰竭1例》一文,所报道之病例确属少见,有参考价值,很值得一读。但对中毒致呼衰的机制笔者有点不同看法,现讨论如下。 阿片壳致呼衰的主要成份应属阿片,阿片虽有抑制中枢的作用,但从该例患者的病史、临床表现和治疗归转来看,呼衰系阿片诱发支气管哮喘危象所致。其理由是:①患者心率140次/分,呼吸30次/分,不是减慢而是增快,肺部叩诊过清音,双肺可闻及喘鸣音及中等量湿啰音。②患者有10年的肺心病史,我国肺心病多有阻塞性肺气肿发展而来,对此类疾病患者阿片类药物属禁用,主要原因是阿片类物质可诱发支气管痉挛而加重支气管阻塞,严重者可诱发支气管哮喘危象致呼衰、心衰, Your Journal published in 1995 24 Road, “Shuijianbi opioid poisoning caused by respiratory failure in 1 case,” a reported case is indeed rare, a reference value, it is worth reading. However, the mechanism of poisoning induced respiratory failure a little different views, are discussed below. Opiate induced respiratory failure should be the main component of opioid opioid although inhibit the role of the center, but from the patient’s history, clinical manifestations and treatment turn point of view, respiratory failure opioid induced bronchial asthma crisis. The reason is: ① patients with heart rate 140 beats / min, breathing 30 beats / min, not slow but faster, percussion lung clearance, lungs can be heard and wheezing and moderate wet rales. ② patients with 10-year history of pulmonary heart disease, pulmonary heart disease in our country more obstructive emphysema developed from opioids in patients with such diseases is banned, mainly due to opioids can induce bronchial spasm and aggravate bronchial obstruction, Serious cases can be induced bronchial asthma crisis induced respiratory failure, heart failure,