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百草枯中毒的临床特征与预后:41例病例回顾

Clinical features and prognosis of paraquat poisoning: a review of 41 cases.

作者信息

Delirrad Mohammad, Majidi Mohammad, Boushehri Behzad

机构信息

Department of Forensic Medicine & Clinical Toxicology, School of Medicine; Member of Food and Beverages Safety Research Center, Urmia University of Medical Sciences Urmia, Iran.

Department of Forensic Medicine & Clinical Toxicology, School of Medicine, Urmia University of Medical Sciences Urmia, Iran.

出版信息

Int J Clin Exp Med. 2015 May 15;8(5):8122-8. eCollection 2015.

Abstract

PURPOSE

Paraquat is a contact herbicide which is highly toxic to human. Deliberate self-poisoning with paraquat continues to be a major public health concern in many developing countries. This study aimed to evaluate the data on cases of acute paraquat poisoning and to compare different variables between survivors and non-survivors.

METHODS

In this cross sectional study, medical records of all paraquat intoxicated patients were reviewed at Taleghani hospital of Urmia, Iran, from 2007 to 2013, retrospectively. Demographics, clinical features and laboratory findings were evaluated. The variables compared between survivors and non-survivors were the amount of paraquat ingested, occurrence of vomiting after ingestion, time and place of hospital admission, length of hospital stay, leukocytosis, serum creatinine level and the outcomes.

RESULTS

A total of 41 patients were evaluated. The mean ± standard deviation of patients' age were 31.6±16.9 years. The Length of hospital stay was 5.75±4.6 days. Most poisonings occurred in spring and summer. The in-hospital fatality rate was 46.3%. Statistically significant associations were found between the outcome of patients and the amount ingested (P=0.001), vomiting (P=0.004), early need to intensive cares (P=0.009), leukocytosis (P=0.001), serum creatinine levels (P=0.001), manifestations of acute hepatic (P<0.001) and respiratory failure (P=0.007).

CONCLUSION

Ingestion of more than 30 ml, prompt vomiting, early need to intensive cares, leukocytosis, and multi-organ failures are major determinants for fatal outcome of paraquat poisoning. It may be useful to educate health professionals and the general population about the serious consequences of exposure to paraquat.

摘要

目的

百草枯是一种对人体有剧毒的触杀型除草剂。在许多发展中国家,蓄意服用百草枯进行自我中毒仍是一个重大的公共卫生问题。本研究旨在评估急性百草枯中毒病例的数据,并比较幸存者和非幸存者之间的不同变量。

方法

在这项横断面研究中,对伊朗乌尔米耶塔莱加尼医院2007年至2013年所有百草枯中毒患者的病历进行了回顾性分析。评估了人口统计学、临床特征和实验室检查结果。比较幸存者和非幸存者的变量包括百草枯摄入量、摄入后呕吐情况、入院时间和地点、住院时间、白细胞增多、血清肌酐水平及预后。

结果

共评估了41例患者。患者年龄的平均值±标准差为31.6±16.9岁。住院时间为5.75±4.6天。大多数中毒事件发生在春季和夏季。院内死亡率为46.3%。发现患者的预后与摄入量(P = 0.001)、呕吐(P = 0.004)、早期需要重症监护(P = 0.009)、白细胞增多(P = 0.001)、血清肌酐水平(P = 0.001)、急性肝损伤表现(P < 0.001)和呼吸衰竭(P = 0.007)之间存在统计学显著关联。

结论

摄入超过30毫升、迅速呕吐、早期需要重症监护、白细胞增多和多器官功能衰竭是百草枯中毒致死结局的主要决定因素。对卫生专业人员和普通人群进行关于接触百草枯严重后果的教育可能会有所帮助。

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