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。%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.
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