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印度南部一家三级医疗中心黄磷中毒的临床谱:病例系列

Clinical spectrum of yellow phosphorous poisoning in a tertiary care centre in South India: a case series.

作者信息

Mishra Ajay Kumar, Devakiruba Nathaniel Samson, Jasmine Sudha, Sathyendra Sowmya, Zachariah Anand, Iyadurai Ramya

机构信息

1 Assistant Professor, Internal Medicine Unit III, Christian Medical College and Hospital Vellore, Tamil Nadu, India.

2 Associate Professor, Internal Medicine Unit III, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

出版信息

Trop Doct. 2017 Jul;47(3):245-249. doi: 10.1177/0049475516668986. Epub 2016 Sep 23.

Abstract

Rodenticides such as yellow phosphorus are highly toxic compounds which are commonly used for pest control. Reports of yellow phosphorus poisoning from tropical nations is scanty. In this retrospective study, we report the clinical features, mortality and predictors of mortality among nine patients at a tertiary care centre in south India. Yellow phosphorus consumption was common among a younger age group of patients. The mean duration of presentation after consumption was five days. The most common clinical manifestations seen were abdominal pain and vomiting followed by a depressed sensorium. Features of acute liver failure including coagulopathy were seen in all patients. Despite all patients receiving supportive therapy, a poor outcome or death resulted in the majority. Early referral to a tertiary care centre, meticulous monitoring and supportive measures are key elements of patient management as there are no specific antidotes available at present. Increase in public and physician awareness to the toxin and implementation of preventive policies is of utmost importance.

摘要

诸如黄磷之类的灭鼠剂是剧毒化合物,常用于害虫防治。来自热带国家的黄磷中毒报告很少。在这项回顾性研究中,我们报告了印度南部一家三级护理中心9例患者的临床特征、死亡率及死亡预测因素。黄磷中毒在较年轻的患者群体中很常见。中毒后就诊的平均时长为5天。最常见的临床表现是腹痛和呕吐,其次是意识不清。所有患者均出现了包括凝血功能障碍在内的急性肝衰竭特征。尽管所有患者均接受了支持治疗,但大多数患者结局不佳或死亡。由于目前没有特效解毒剂,早期转诊至三级护理中心、细致监测和支持措施是患者管理的关键要素。提高公众和医生对该毒素的认识以及实施预防政策至关重要。

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