抗凝血灭鼠剂中毒致凝血异常12例临床分析

Coagulation Disorder Caused by Anticoagulant Rodenticide Poisoning:A clinical analysis of 12 cases

目的研究长效抗凝血灭鼠剂中毒的临床特点和治疗方法。方法回顾性分析抗凝血灭鼠剂中毒患者12例的临床表现、实验室检查、诊断和治疗。结果(1)患者出血表现多样,出血症状重,血小板计数基本正常,血浆凝血酶原时间(PT)、活化部分凝血酶时间(APTT)明显延长;(2)治疗前后患者的PT、APTT、血红蛋白(Hb)间差异有统计学意义(P<0.01)。结论抗凝血灭鼠剂中毒致凝血异常患者病史隐匿、容易误诊,为获得性维生素K依赖的凝血因子减少导致的凝血功能异常。

Objective To investigate the clinical characteristics of poisoning caused by long- acting anticoagulant rodenticide and its therapeutic methods. Methods Retrospective analysis was performed on the data of clinical manifestations, routine examinations, diagnoses and treatments of 12 patients with clear histories of anticoagulant rodenticide poisoning. Results The presentations of hemorrhage of the patients were many and various, the bleeding symptoms were serious. Laboratory examinations showed basically normal platelet count, prolonged plasma prothrombin time （PT） and activated partial prothrombin time PT （AT）. There were significant differences in PT, APTF and Hb of the patients before and after treatment （ P 〈 0. 01 ）. Conclusion The histories are usually delitescent in patients with coagulation disorder caused by anticoagulant rodenticide poisoning. So it is easily misdiagnosed, and the coagulation function disorder is due to acquired reduction of vitamin K - dependent blood coagulation factors.