一例采用连续性血液透析滤过治疗的重度百草枯中毒病例，无后遗症。

A case of severe paraquat poisoning treated by continuous hemodiafiltration without sequelae.

作者信息

Hisamura Masaki, Ogura Tomoyuki, Tokuda Mitsuhiro, Nakamura Motohiro, Kenichiro Sonoda, Ando Yoji, Nakata Kazuyuki, Taguchi Hirokazu

机构信息

Department of Emergency Medicine, Saitama Medical Center Saitama Medical University Kawagoe City Saitama Japan.

Clinical Training Center, Saitama Medical Center Saitama Medical University Kawagoe City Saitama Japan.

出版信息

Acute Med Surg. 2023 Mar 7;10(1):e833. doi: 10.1002/ams2.833. eCollection 2023 Jan-Dec.

DOI:10.1002/ams2.833

PMID:36895322

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9990155/

Abstract

BACKGROUND

In a suicide attempt, a 49-year-old male ingested pesticides. He arrived at the hospital restless and vomiting blue liquid.

CASE PRESENTATION

The patient was diagnosed with paraquat poisoning at a lethal dose and experienced renal dysfunction during treatment. He underwent continuous hemodiafiltration (CHDF). Hemodialysis was temporarily initiated and found to improve renal function. He was discharged on day 36 in good condition. He remains well with only mild renal impairment and no pulmonary fibrosis, 240 days after the incident. The fatality rate of paraquat poisoning is approximately 80%, regardless of the treatment. Early hemodialysis combined with CHDF within 4 h has been reported to be effective. In this case, CHDF was initiated approximately 3 h after paraquat administration and showed a successful outcome.

CONCLUSION

CHDF should be performed as soon as possible to treat paraquat poisoning.

摘要

背景

一名49岁男性在自杀未遂时摄入了农药。他抵达医院时烦躁不安，呕吐蓝色液体。

病例介绍

该患者被诊断为致死剂量的百草枯中毒，治疗期间出现肾功能障碍。他接受了持续血液透析滤过（CHDF）治疗。临时进行了血液透析，发现肾功能有所改善。他在第36天状况良好出院。事件发生240天后，他仅存在轻度肾功能损害，无肺纤维化，身体状况良好。无论采用何种治疗方法，百草枯中毒的死亡率约为80%。据报道，在4小时内尽早进行血液透析联合CHDF是有效的。在本病例中，百草枯给药后约3小时开始进行CHDF，取得了成功的治疗效果。