CAJ | 학술논문

目的：总结抗凝血杀鼠剂中毒的临床表现、诊断和治疗方法。方法回顾性分析我科2012年2月-2014年3月收治的6例抗凝血杀鼠剂中毒患者的病历资料，并结合文献进行回顾性分析。结果6例以血尿、口鼻腔出血为主要表现，出血不易自止。3例以血尿为首发临床表现，其中1例伴发口鼻腔出血；2例以口鼻腔出血为主要表现，其中1例伴皮肤瘀点、瘀斑及头痛；1例无出血症状。3例白细胞计数增高，5例血红蛋白水平降低；5例凝血酶原时间、活化部分凝血酶原时间、凝血酶时间延长，凝血酶原活动度降低。凝血因子Ⅱ、Ⅶ、Ⅸ、Ⅹ活性下降。补充维生素K1或新鲜冷冻血浆(或凝血酶原复合物)后出血控制。结论以广泛性多部位出血为主要表现的患者要注意抗凝血杀鼠剂中毒的可能，治疗以补充维生素K1为主。
목적：총결항응혈살서제중독적림상표현、진단화치료방법。방법회고성분석아과2012년2월-2014년3월수치적6례항응혈살서제중독환자적병력자료，병결합문헌진행회고성분석。결과6례이혈뇨、구비강출혈위주요표현，출혈불역자지。3례이혈뇨위수발림상표현，기중1례반발구비강출혈；2례이구비강출혈위주요표현，기중1례반피부어점、어반급두통；1례무출혈증상。3례백세포계수증고，5례혈홍단백수평강저；5례응혈매원시간、활화부분응혈매원시간、응혈매시간연장，응혈매원활동도강저。응혈인자Ⅱ、Ⅶ、Ⅸ、Ⅹ활성하강。보충유생소K1혹신선냉동혈장(혹응혈매원복합물)후출혈공제。결론이엄범성다부위출혈위주요표현적환자요주의항응혈살서제중독적가능，치료이보충유생소K1위주。
Objective To analyze the mechanism, clinical characteristics, diagnoses and treatments of anticoagulant rodenticides poisoning.Methods Six cases diagnosed with anticoagulant rodenticides poisoning in our department since 2012 were enrolled in this study and its related literatures were reviewed.Results Poisoning was characterized by hematuria, bleeding of oral and nasal cavities in 6 patients. Of the 6 cases, 3 patients presented with hematuria as primary clinical manifestation and one of them was accompanied by bleeding of oral and nasal cavities; 2 were accompanied by oral mucosal bleeding and 1 by skin petechiae or ecchymoses; 1 without bleeding symptom. The white blood count (WBC) elevated mildly in 3 patients, hemoglobin level decreased in 5 cases; prothrombin time, activated partial prothrombin time and thrombin time were prolonged and activity of thrombinogen reduced in 5 patients. Coagulation factorⅡ Ⅶ,Ⅸ,Ⅹdecreased. Hemorrhage was effective after supplementary of vitamin K1 or fresh frozen plasma (or prothrombin complex).ConclusionPrimary manifestation being hemorrhage of multiple sites should be taken into account the possibility of anticoagulant rodenticides poisoning, which is mainly treated by supplementary of vitamin K1.