Department of Poisoning and Occupational Disease, Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
Department of Intensive Care Medicine (ICU), The First Affiliated Hospital of the University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China.
Sci Prog. 2021 Apr-Jun;104(2):368504211019647. doi: 10.1177/00368504211019647.
To analyze the clinical characteristics and therapeutic effects of transoral paraquat poisoning combined with Esophagitis dissecans superficialis (EDS). A retrospective observational study was conducted on paraquat poisoning patients between January 1, 2011 and August 30, 2016 in Qilu hospital. Fifteen patients with EDS were enrolled in this study. The clinical characteristics, prognosis, and pathological features of esophageal necrosis mucosa of these patients were retrospectively analyzed and summarized. Esophageal mucosal dissection occurs mainly within 3-8 days after transoral paraquat poisoning in 15 patients. Dosage of paraquat is range from 50 to 100 ml. Most patients have physical problems with swallowing before the intramural esophageal dissection occurred. And there are other symptoms, including sore throat or dysphagia (100%), nausea and vomiting (86.7%), heartburn or upper abdominal pain (73.3%), hematemesis (60%), abdominal distension (20%) and cough frequently (6.7%). In death group, most patients demonstrate features of the multiple organ failure when the esophageal mucosal stripping happened, including lung injury, renal failure, and hepatic failure. The shape of esophageal dissection was tubular in 60%, irregular in 40%, and they vary in size. Pathological examination showed extensive injury, necrosis and hemorrhage of digestive tract epithelium, and obvious inflammatory reaction of epithelial tissue. Transoral paraquat poisoning has certain damage to the patient's esophageal mucosa, and some may be complicated with EDS, and the prognosis is poor, especially when combined with multiple organ dysfunction. Esophageal damage is mainly located in the esophageal mucosa and have different degrees. Special attention should be paid on such patients.
分析经口百草枯中毒合并食管黏膜浅层剥离症（EDS）的临床特点及治疗效果。采用回顾性观察研究方法，收集 2011 年 1 月 1 日至 2016 年 8 月 30 日齐鲁医院收治的经口百草枯中毒患者资料，共纳入 15 例 EDS 患者，对其临床特点、预后及食管坏死黏膜的病理特点进行回顾性分析和总结。15 例患者均发生于经口百草枯中毒后 38 d，百草枯中毒剂量 50100 ml，均在发生食管壁内剥离前存在吞咽困难等躯体问题，同时存在咽痛或吞咽困难（100%）、恶心呕吐（86.7%）、烧心或上腹痛（73.3%）、呕血（60%）、腹胀（20%）、频繁咳嗽（6.7%）等症状。死亡组患者发生 EDS 时多已存在多器官功能衰竭表现，如肺损伤、肾衰竭、肝衰竭等。食管剥离形态管状占 60%、不规则形占 40%，大小不一。病理检查均表现为消化道上皮广泛损伤、坏死、出血，上皮组织明显炎症反应。经口百草枯中毒对食管黏膜有一定损害，部分可合并 EDS，预后差，尤其合并多器官功能障碍时。食管损伤主要位于食管黏膜，程度不一，对此类患者应予以重视。
