ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (7): 846-848.doi: 10.3761/j.issn.2096-7446.2026.07.011

• 急症护理研究 • 上一篇    下一篇

109例注射性A型肉毒毒素中毒患者的快速识别及护理

章亿香1(), 吕炜2,*(), 何翠丽3, 刘丽萍2, 农康3, 谢芳娜4   

  1. 1 广西壮族自治区工人医院护理部 南宁市 530021
    2 广西壮族自治区工人医院办公室 南宁市 530021
    3 广西壮族自治区工人医院中毒肾内科 南宁市 530021
    4 广西壮族自治区工人医院老年医学科 南宁市 530021
  • 收稿日期:2025-12-16 出版日期:2026-07-10 发布日期:2026-07-01
  • 通讯作者: *吕炜，E-mail：517386998@qq.com
  • 作者简介:章亿香：女，本科，副主任护师，E-mail：yixiang_lu@126.com
    作者贡献声明

    章亿香、吕炜、何翠丽：研究实施、循证分析、论文撰写；刘丽萍、农康：研究指导；谢芳娜：论文修改

  • 基金资助:
    广西壮族自治区卫生健康委自筹课题(Z-A20230406)

Rapid identification and nursing for 109 patients with botulinum toxin type A injection-induced poisoning

ZHANG Yixiang1(), LÜ Wei2,*(), HE Cuili3, LIU Liping2, NONG Kang3, XIE Fangna4   

  1. 1 Department of Nursing， Workers’ Hospital of Guangxi Zhuang Autonomous Region， Nanning 530021， China
    2 General Office， Workers’ Hospital of Guangxi Zhuang Autonomous Region， Nanning 530021， China
    3 Toxic Nephrology Department， Workers’ Hospital of Xizhuang Autonomous Region， Nanning 530021， China
    4 Geriatrics Department， Workers’ Hospital of Guangxi Zhuang Autonomous Region， Nanning 530021， China
  • Received:2025-12-16 Online:2026-07-10 Published:2026-07-01
  • Contact: *Lü Wei，E-mail：517386998@qq.com
  • Supported by:
    Self-funded Research Project of the Health Commission of Guangxi Zhuang Autonomous Region(Z-A20230406)

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摘要：

目的 总结109例注射性A型肉毒毒素中毒患者的快速识别及护理经验，为临床提供参考。方法 回顾分析2024年7月—2025年9月收治的109例注射性A型肉毒毒素中毒患者的临床资料。围绕“快速识别”核心，按疾病发展时间轴实施护理，重点包括入院接诊期基于症状核查表的快速识别流程与抗毒素用药安全监护、急性期基于预警阈值的呼吸分级监护与气道管理、呼吸衰竭期机械通气患者的早期康复训练、恢复期的阶梯式吞咽康复训练及辅助护理，以及贯穿全程的分层心理支持。结果 18例机械通气患者均成功脱机，84例吞咽困难患者恢复经口进食；所有患者均未发生并发症，中位住院时间5 d。结论 对注射性A型肉毒毒素中毒患者实施快速识别及分层、动态、个体化护理干预，可提高其康复依从性，促进功能恢复，缩短住院时间。

关键词: 肉毒毒素A型, 肉毒中毒, 呼吸疗法, 吞咽康复, 急性期护理

Abstract:

Objective To summarize the rapid identification and nursing experience of 109 patients with botulinum toxin type A injection-related poisoning，and to provide clinical reference. Methods Clinical data of 109 patients with botulinum toxin type A injection-related poisoning admitted to a tertiary occupational disease hospital from July 2024 to September 2025 were retrospectively analyzed. Centered around the core of rapid identification， nursing interventions were implemented along the timeline of disease progression，including rapid identification process based on symptom checklists during hospitalization and safety monitoring of antitoxin administration during the admission phase，respiratory graded monitoring based on warning thresholds and airway clearance during the acute phase，early active and passive rehabilitation training for patients receiving mechanical ventilation during the respiratory failure phase，stepwise swallowing rehabilitation and comprehensive assisted nursing during the recovery phase，and layered narrative psychological support throughout the whole course. Results All 18 patients on mechanical ventilation were successfully weaned，and 84 patients with dysphagia resumed oral feeding. No complications occurred in any patient，and the median hospital stay was 5 days. Conclusion Rapid identification and stratified，dynamic，and individualized nursing interventions for patients with injection-related botulinum toxin type A poisoning can improve rehabilitation compliance，promote functional recovery，and shorten hospital stay.

Key words: Botulinum Toxin Type A, Botulism, Respiratory Therapy, Swallowing Rehabilitation, Critical Care Nursing