中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2011年
7期
519-521
,共3页
史晶%高渝峰%黄澎%曾润生
史晶%高渝峰%黃澎%曾潤生
사정%고투봉%황팽%증윤생
百草枯%中毒%多器官功能衰竭%呼吸窘迫综合征
百草枯%中毒%多器官功能衰竭%呼吸窘迫綜閤徵
백초고%중독%다기관공능쇠갈%호흡군박종합정
Paraquat%Poisoning%Multiple organ failure%Respiratory distress syndrome
目的 探讨急性百草枯中毒致多器官功能障碍综合征(MODS)的临床特点.方法 回顾分析2005年6月至2009年6月收治的68例口服百草枯中毒患者的临床资料,所有人选患者服毒到救治的时间均＜24 h,依据临床结局分为病死组37例和存活组31例,分析两组病例的服毒至就诊时间、服毒剂量、治疗5 d内MODS出现的时间以及受损器官数目.结果 68例患者中发生急性呼吸窘迫综合征(ARDS)35例,发生率为51.47%,急性肺损伤(ALI)的发生率为97.1%(66/68例),中毒患者的病死率为54.4%(37/68例).病死组患者服毒至就诊时间和服毒剂量明显高于存活组,差异有统计学意义(P＜0.05,P＜0.01).病死组患者MODS器官数目＞3个的构成比(70.27%)明显高于存活组(38.71%),差异有统计学意义(P＜0.01),病死组患者MODS出现时间和ALI/ARDS出现时间,明显低于存活组,差异有统计学意义(P＜0.05).百草枯中毒病例的中毒性心肌、肝、肾等损害较肺损伤出现早.结论 急性百草枯中毒导致的MODS出现时间早、病情凶险而且病死率高,以肺损伤为主的MODS是导致死亡的主要原因,服毒至就诊时间和中毒剂量是影响患者预后的重要因素之一.
目的 探討急性百草枯中毒緻多器官功能障礙綜閤徵(MODS)的臨床特點.方法 迴顧分析2005年6月至2009年6月收治的68例口服百草枯中毒患者的臨床資料,所有人選患者服毒到救治的時間均＜24 h,依據臨床結跼分為病死組37例和存活組31例,分析兩組病例的服毒至就診時間、服毒劑量、治療5 d內MODS齣現的時間以及受損器官數目.結果 68例患者中髮生急性呼吸窘迫綜閤徵(ARDS)35例,髮生率為51.47%,急性肺損傷(ALI)的髮生率為97.1%(66/68例),中毒患者的病死率為54.4%(37/68例).病死組患者服毒至就診時間和服毒劑量明顯高于存活組,差異有統計學意義(P＜0.05,P＜0.01).病死組患者MODS器官數目＞3箇的構成比(70.27%)明顯高于存活組(38.71%),差異有統計學意義(P＜0.01),病死組患者MODS齣現時間和ALI/ARDS齣現時間,明顯低于存活組,差異有統計學意義(P＜0.05).百草枯中毒病例的中毒性心肌、肝、腎等損害較肺損傷齣現早.結論 急性百草枯中毒導緻的MODS齣現時間早、病情兇險而且病死率高,以肺損傷為主的MODS是導緻死亡的主要原因,服毒至就診時間和中毒劑量是影響患者預後的重要因素之一.
목적 탐토급성백초고중독치다기관공능장애종합정(MODS)적림상특점.방법 회고분석2005년6월지2009년6월수치적68례구복백초고중독환자적림상자료,소유인선환자복독도구치적시간균＜24 h,의거림상결국분위병사조37례화존활조31례,분석량조병례적복독지취진시간、복독제량、치료5 d내MODS출현적시간이급수손기관수목.결과 68례환자중발생급성호흡군박종합정(ARDS)35례,발생솔위51.47%,급성폐손상(ALI)적발생솔위97.1%(66/68례),중독환자적병사솔위54.4%(37/68례).병사조환자복독지취진시간화복독제량명현고우존활조,차이유통계학의의(P＜0.05,P＜0.01).병사조환자MODS기관수목＞3개적구성비(70.27%)명현고우존활조(38.71%),차이유통계학의의(P＜0.01),병사조환자MODS출현시간화ALI/ARDS출현시간,명현저우존활조,차이유통계학의의(P＜0.05).백초고중독병례적중독성심기、간、신등손해교폐손상출현조.결론 급성백초고중독도치적MODS출현시간조、병정흉험이차병사솔고,이폐손상위주적MODS시도치사망적주요원인,복독지취진시간화중독제량시영향환자예후적중요인소지일.
Objective To analysis clinical characteristics of the multiple organ dysfunction syndrome (MODS) caused by acute paraquat poisoning(APP). Method Clinical data of 68 APP cases from Jan 2006 to Jun 2009, including age, gender, poisoning time and dosage, and MODS time, were compared in two groups, i.e.the death (37 cases) and survived (31 cases) groups. It was less than 24 hours from poisoning to rescue in all cases. Results Among the 68 cases, the incident rate of ARDS was 51.47% (35 cases). The rate of acute lung injure was 97.1% (66 cases). The mortality was 54.4% (37 cases). There was no significant difference in age and gender between both groups (P＞0.05). The dosages and times from poisoning to rescue were significant different between two groups (P＜0.05, P＜0.01). In the death group, proportion of amounts (＞3) of organs related with MODS was 70.29%, which was significantly higher than that (38.71%) in survived group (P＜0.01). MODS and ALI/ARDS occurred in death group earlier than those in survival group (P＜0.05). On the other hand, cardiac, hepatic and renal damage occurred earlier than the lung injure. Conclusion MODS in APP patients occurred earlier, were more sever, and caused higher mortality. The poisoning dosage and time were important prognostic factors.
