Gear A J, Ahrenholz D H, Solem L D
Department of Plastic and Hand Surgery, Regions Hospital (a University of Minnesota-affiliated hospital), Saint Paul 55101, USA.
J Burn Care Rehabil. 2001 Sep-Oct;22(5):347-51; discussion 346. doi: 10.1097/00004630-200109000-00011.
Paraquat is a bipyridyl compound widely used as a contact herbicide. Since its introduction in 1962, hundreds of deaths have occurred, usually after suicidal or accidental ingestion. Death after dermal absorption of paraquat is uncommon, but has occurred after either contact with undiluted paraquat, disruption of skin integrity, or prolonged exposure. It is the purpose of this case report to describe a patient who had fatal dermal paraquat absorption after a crop-dusting accident in which he sustained 37% TBSA burns. After 9.5 hours of cutaneous exposure, a paraquat level of 0.169 mg/ml was obtained at 20 hours, the standard lethal dose at 16 hours being 0.16 mg/ml. In light of the apparently irreversible pathophysiology of paraquat poisoning with plasma levels as low as 3 mg/L, prevention and early intervention are the best treatments. Our patient may have survived an otherwise routine thermal injury had his wounds been aggressively irrigated in the field.
百草枯是一种广泛用作接触性除草剂的联吡啶化合物。自1962年引入以来，已发生数百起死亡事件，通常是在自杀或意外摄入之后。经皮肤吸收百草枯后死亡的情况并不常见，但在接触未稀释的百草枯、皮肤完整性受损或长时间接触后会发生。本病例报告的目的是描述一名患者，他在一次农作物喷洒事故中遭受了37%体表面积的烧伤，之后经皮肤吸收百草枯致死。皮肤暴露9.5小时后，在20小时测得百草枯水平为0.169毫克/毫升，16小时的标准致死剂量为0.16毫克/毫升。鉴于血浆水平低至3毫克/升时百草枯中毒的病理生理过程显然不可逆转，预防和早期干预是最佳治疗方法。如果患者在现场对伤口进行积极冲洗，他可能会从原本常规的热损伤中存活下来。
