CAJ | 학술논문

【目的】探讨百草枯中毒患者的治疗方法，并对影响其预后的因素进行分析。【方法】选择本院2011年8月至2013年5月收治住院的百草枯中毒患者34例的临床资料进行回顾性分析，研究对象分为生存组和死亡组，对比两组患者服毒剂量、首次呕吐时间、就诊时间、首次灌流时间及并发症对预后的影响，并测定血液灌流前后百草枯的浓度、超氧化物歧化酶（SOD ）活力的变化。【结果】34例患者中10例生存（生存组），24例死亡（死亡组），病死率70．59％。血液灌流后患者血浆百草枯浓度明显降低而SOD活力明显增高，且与灌流前相比差异均有显著性（ P ＜0．05）；死亡组患者服毒剂量明显多于、首次呕吐时间明显早于存活组，且两组比较差异有显著性（ P ＜0．05）；死亡组就诊时间、首次灌流时间明显晚于存活组，且两组比较差异有显著性（P ＜0．05）；死亡组并发症发生率明显高于生存组，且两组比较差异有显著性（P ＜0．05）。【结论】对百草枯中毒患者要尽快地施行急救措施，多种因素会影响患者的预后，其中服毒剂量、SOD活力、百草枯的浓度、首次呕吐时间、就诊时间、首次灌流时间及并发症对预后影响非常关键。临床上应对百草枯中毒患者进行早期全方位治疗。
【목적】탐토백초고중독환자적치료방법，병대영향기예후적인소진행분석。【방법】선택본원2011년8월지2013년5월수치주원적백초고중독환자34례적림상자료진행회고성분석，연구대상분위생존조화사망조，대비량조환자복독제량、수차구토시간、취진시간、수차관류시간급병발증대예후적영향，병측정혈액관류전후백초고적농도、초양화물기화매（SOD ）활력적변화。【결과】34례환자중10례생존（생존조），24례사망（사망조），병사솔70．59％。혈액관류후환자혈장백초고농도명현강저이SOD활력명현증고，차여관류전상비차이균유현저성（ P ＜0．05）；사망조환자복독제량명현다우、수차구토시간명현조우존활조，차량조비교차이유현저성（ P ＜0．05）；사망조취진시간、수차관류시간명현만우존활조，차량조비교차이유현저성（P ＜0．05）；사망조병발증발생솔명현고우생존조，차량조비교차이유현저성（P ＜0．05）。【결론】대백초고중독환자요진쾌지시행급구조시，다충인소회영향환자적예후，기중복독제량、SOD활력、백초고적농도、수차구토시간、취진시간、수차관류시간급병발증대예후영향비상관건。림상상응대백초고중독환자진행조기전방위치료。
To explore the treatment method of paraquat poisoning and analyze the influential factors of prognosis .[Methods]Clinical data of 34 patients with paraquat poisoning admitted to our hospital from Aug .2011 to May 2013 were analyzed retrospectively .All patients were divided into survival group and death group .The effect of the poisoning concentration ,first vomiting time ,the visiting time ,first perfusion time and complications on the prognosis was compared between two groups .The changes of paraquat concen-tration and superoxide dismutase(SOD) before and after blood perfusion were measured .[Results] Of 34 pa-tients ,10 patients survived(survival group) and 24 patients died (death group) ,and the mortality rate was 70 .59% .Plasma levels of paraquat after blood perfusion were obviously decreased ,but SOD activity was obvi-ously increased ,and there was significant difference between before and after blood perfusion ( P<0 .05) .The poisoning dose in the death group was obviously more than that in the survival group ,but the first vomiting time in the death group was obviously earlier than that in the survival group ,and there was significant differ-ence between two groups( P<0 .05) .The visiting time and first blood perfusion time in the death group were obviously later than those in the survival group ,and there was significant difference between two groups ( P<0 .05) .The incidence of complications in the death groups is higher than that in the survival group ,and there was significant difference between two groups( P<0 .05) .[Conclusion] Emergent first-aid measure should be performed as quickly as possible for patients with paraquat poisoning .Many factors can affect the prognosis . The poisoning doses ,SOD activity ,the concentration of paraquat ,first vomiting time ,the visiting time ,first blood perfusion time and complications are the very critical for the prognosis .Therefore ,early comprehensive treatment to deal with patients with paraquat poisoning should be taken in clinical practice .