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百草枯中毒:印度南部马尼帕尔致命中毒罕见原因分析

Paraquat Poisoning: Analysis of an Uncommon Cause of Fatal Poisoning from Manipal, South India.

作者信息

Kanchan Tanuj, Bakkannavar Shankar M, Acharya Preetham R

机构信息

Department of Forensic Medicine, Kasturba Medical College, Mangalore, Karnataka, India.

Department of Forensic Medicine, Kasturba Medical College, Manipal (Constituent Colleges of Manipal University), Karnataka, India.

出版信息

Toxicol Int. 2015 Jan-Apr;22(1):30-4. doi: 10.4103/0971-6580.172253.

Abstract

BACKGROUND

Morbidity and mortality related to acute poisoning is a serious health concern worldwide. Paraquat is known to be responsible for a number of acute poisonings in south India.

AIM

The study aims at presenting the various aspects of paraquat poisoning that include patient profile, clinical presentation, end-organ complications, and observations at autopsy.

MATERIALS AND METHODS

The present registry-based retrospective research was conducted in a tertiary care teaching hospital in south India. All the confirmed cases of paraquat poisoning were included in the present study. The postmortem and hospital records of these patients were retrieved and relevant information was collected and analyzed.

RESULTS

Paraquat poisonings constituted 14.4% of the total poisoning fatalities during the study period. Equal number of males and females were observed in the present study. The victims were aged between 17 and 65 years (mean ± SD = 30.2 ± 13.1 years). Manner of death was suicidal in 92.9% cases. Common presenting symptoms after ingestion of paraquat included vomiting, followed by difficulty in breathing. In the present series, overall survival post paraquat consumption ranged between 10 h and 25 days. Half of the victims died within 2 days of consumption of poison. The underlying cause of death included acute renal failure (ARF), adult respiratory distress syndrome (ARDS), multiorgan failure (MOF), acute liver failure, etc., In all the cases, brain was congested and edematous, and visceral organs showed marked congestion at autopsy. Lungs were congested with marked edema in 10 cases.

CONCLUSION

It is recommended that the availability of this highly toxic substance be restricted so as to prevent its misuse as a method of suicide.

摘要

背景

与急性中毒相关的发病率和死亡率是全球范围内严重的健康问题。在印度南部,百草枯是导致多起急性中毒事件的原因。

目的

本研究旨在呈现百草枯中毒的各个方面,包括患者概况、临床表现、终末器官并发症以及尸检观察结果。

材料与方法

本基于登记处的回顾性研究在印度南部的一家三级护理教学医院进行。所有确诊的百草枯中毒病例均纳入本研究。检索了这些患者的尸检和医院记录,并收集和分析了相关信息。

结果

在研究期间,百草枯中毒占总中毒死亡人数的14.4%。本研究中观察到男性和女性数量相等。受害者年龄在17至65岁之间(平均±标准差 = 30.2 ± 13.1岁)。92.9%的病例死亡方式为自杀。摄入百草枯后常见的症状包括呕吐,其次是呼吸困难。在本系列中,百草枯摄入后的总体存活时间为10小时至25天。一半的受害者在摄入毒物后2天内死亡。死亡的根本原因包括急性肾衰竭(ARF)、成人呼吸窘迫综合征(ARDS)、多器官功能衰竭(MOF)、急性肝衰竭等。在所有病例中,尸检时脑部充血水肿,内脏器官显示明显充血。10例患者肺部充血并伴有明显水肿。

结论

建议限制这种剧毒物质的可得性,以防止其被滥用作自杀手段。

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