敌鼠钠中毒误诊分析

Analysis of misdiagnosis of sodium diphacinone poisoning

目的探索敌鼠钠中毒的临床特点和治疗方法。方法前瞻性总结敌鼠钠中毒患者11例的临床表现、诊断和治疗过程,以及治疗前后凝血功能的变化和治疗效果。结果中毒患者出血延迟,表现多样,涉及多个系统,全部病例首诊误诊率为100%。结论敌鼠钠中毒患者误诊率高,误诊原因包括病史隐匿,患者否认药物接触史,医护人员诊断思路局限,不熟悉该类毒物出血症状迟发的临床表现及群发特点等。详细的病史收集,医护人员熟悉此类灭鼠剂的毒性与临床表现,将有利于临床制定治疗方案和措施。

【Objective】 To explore the clinical features and treatment of sodium diphacinone poisoning.【Methods】Prospectively summarize the clinical signs and symptom、criteria of diagnosis、treatment and the variation of coagulation prior to and after therapy and treatment efficacy of 10 patients suffered from sodium diphacinone poisoning.【Results】The clinical manifestation of the patients＇ suffered from sodium diphacinone poisoning were various,multiple organ were involved,the misdiagnostic rate was as high as 100%.【Conclusion】The misdiagnostic rate of sodium diphacinone poisoning was high.The reasons for misdiagnosis included a hidden medical history,the onset of the signs of poisoning may be delayed and more than one organ is involved;and emergency physicians are unfamiliar with this substance＇s multiple manifestation.To reduce this happen,a detailed patient history data should be collected,and manifestations should be reviewed systemically to improve diagnostic accuracy.Physicians should know the consequences of ingesting these compounds,since they are now widely available,need to consider this diagnosis in any patient presenting with coagulopathy of unclear etiology.