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甲醇中毒的预后因素。

Prognostic factors in methanol poisoning.

作者信息

Hassanian-Moghaddam H, Pajoumand A, Dadgar S M, Shadnia Sh

机构信息

Poison Control Center, Loghman-Hakim Hospital, School of Medicine, Shaheed Beheshti Medical University, Tehran, Iran.

出版信息

Hum Exp Toxicol. 2007 Jul;26(7):583-6. doi: 10.1177/0960327106080077.

Abstract

The aim of this study was to assess the clinical and laboratory factors in methanol poisoned patients to determine the prognosis of their toxicity. This survey was done as a prospective cross-sectional study in methanol-poisoned patients in Loghman-Hakim hospital poison center during 9 months from October 1999-June 2000. During this time 25 methanol-poisoned patients were admitted. The mortality rate was 12 (48%). Amongst survivors, three (23%) of the patients developed blindness due to their poisoning and the other 10 (77%) fully recovered without any complication. The mortality rate in comatose patients was nine (90%) while in non-comatose patients it was three (20%) (P<0.001). There was a significant difference in mean pH in the first arterial blood gas of patients who subsequently died (6.82+/-0.03) and survivors (7.15+/-0.06) (P<0.001, M-W). The mean time interval between poisoning and ED presentation in deceased patients were (46+/-15.7) hours, in survived with sequelae were (16.7+/-6.7) and in survived without sequelae were (10.3+/-7.2) hours (P<0.002, K-W). We found no significant difference between the survivors versus the patients who died regarding methanol. Simultaneous presence of ethanol and opium affected the outcome of the treatment for methanol intoxication favourably and unfavourably, respectively. In our study, poor prognosis was associated with pH<7, coma on admission and >24 hours delay from intake to admission.

摘要

本研究的目的是评估甲醇中毒患者的临床和实验室因素,以确定其毒性的预后情况。本调查是一项前瞻性横断面研究,于1999年10月至2000年6月的9个月期间,在洛格曼 - 哈基姆医院中毒中心对甲醇中毒患者进行。在此期间,收治了25例甲醇中毒患者。死亡率为12例(48%)。在幸存者中,3例(23%)患者因中毒导致失明,另外10例(77%)完全康复且无任何并发症。昏迷患者的死亡率为9例(90%),而非昏迷患者的死亡率为3例(20%)(P<0.001)。随后死亡的患者首次动脉血气中的平均pH值(6.82±0.03)与幸存者(7.15±0.06)之间存在显著差异(P<0.001,M-W)。死亡患者中毒至急诊科就诊的平均时间间隔为(46±15.7)小时,有后遗症的幸存者为(16.7±6.7)小时,无后遗症的幸存者为(10.3±7.2)小时(P<0.002,K-W)。我们发现幸存者与死亡患者在甲醇方面无显著差异。同时存在乙醇和鸦片分别对甲醇中毒的治疗结果产生有利和不利影响。在我们的研究中,预后不良与pH<7、入院时昏迷以及摄入至入院延迟>24小时有关。

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