急性百草枯中毒25例临床分析

Clinical analysis of 25 cases of acute paraquat poisoning

目的探讨急性百草枯(paraquat)中毒的临床表现及预后因素。方法对25例急性百草枯中毒住院患者的临床资料进行回顾性分析。结果死亡13例,死亡率52.0%。可有局部刺激症状及肺、肝、肾、心、神经系统、血液系统损害。死亡率随服毒量增大而增加,服毒量>50 ml 4例全部死亡。白细胞>200×109/L者8例、低血压及昏迷患者全部死亡。10例行血液灌流,死亡7例,死亡率70.0%。6例行血液灌流+血浆置换,死亡2例,死亡率33.3%。结论急性百草枯中毒可引起多脏器损害。早期洗胃及血液灌流+血浆置换可降低死亡率,白细胞>200×109/L者、低血压、昏迷患者预后极差。

Objective To investigate the clinical presentations and prognostic factors of acute paraquat intoxication. Methods A retrospectively analysis was conducted on the clinical data of the admitted 25 patients with acute paraquat intoxication within the past 5 years. Results Of the total number,13 cases died,with a mortality of 52.0%.The complications occurring in cases included local irritation as well as lung,hepatic,renal,cardiac,nervous system and blood system function impairment.Mortality augmented with the increasing intake of the poison.14 cases that took more than 50 ml,8 cases with WBC〉 200 × 109,hypotension or coma all died.10 cases were treated with routine therapy and hemoperfusion,of whom there were 7 deaths,with a mortality of 70.0%.Of the 6 cases treated with hemoperfusion and plasma exchange,2 cases died,with a mortality of 33.3%.Conclusions Acute paraquat intoxication can cause multiple organ function impairment.Early gastric lavage,hemoperfusion plus plasma exchange can reduce the mortality.Very poor prognosis occurred in patients with WBC〉 200 ×109,low blood pressure or coma.