呼吸道吸入兼皮肤吸收百草枯所致中毒6例临床分析

Clinical analysis on 6 cases of poisoning due to the respiratory inhalation and cutaneous absorption of paraquat

目的分析经呼吸道吸入兼皮肤吸收百草枯所致中毒的临床特点。方法对6例经呼吸道吸入兼皮肤吸收百草枯所致中毒患者临床资料进行回顾性分析。结果患者主要经呼吸道吸入兼皮肤吸收百草枯发病;临床表现有口腔、咽部、鼻腔及眼部刺激症状、溃疡或炎症表现,以及胸闷、气促、咳嗽等呼吸系统症状,并伴不同程度的肺、肝、肾、心多脏器损伤,以肺损伤最为严重;肺部感染为主要并发症;早期、足量糖皮质激素冲击治疗有效;6例患者均存活。结论呼吸道吸入兼皮肤吸收百草枯导致的中毒,早期使用糖皮质激素及采取抗氧化、抗纤维化等综合治疗措施,积极防治肺部感染,保护肝、肾和心功能是提高此类患者存活率的关键。

Objective To investigate the clinical manifestations of poisoning due to respiratory inhalation and cutaneous absorption of paraquat .Methods Six cases of poisoning due to respiratory inhalation and cutaneous absorption of paraquat were analyzed retrospectively .Results The occurrence of paraquat poisoning was mainly caused by respiratory inhalation and cutaneous absorption .The major clinical manifestations included irritation symptoms , ulceration and inflammations in the oral cavity , pharynx , naval cavity and the eyes , respiratory symptoms such as shortness of breath , chest distress and cough, damages taking place in lung , liver, kidney and heart in various degrees , with the lung damage being the most seri-ous, pulmonary infection was the major complication .The early treatment was mainly based on the use of glucocorticoid in time at sufficient dose .All six cases survived .Conclusion For patients with poisoning due to respiratory the inhalation and cutaneous absorption of paraquat , the key factors to increase the survival rate can including taking early comprehensive treatment measures like the use of glucocorticoid in time at sufficient dose , antioxidant and anti-pulmonary fibrosis therapy etc.to proactively protect the normal function of liver , kidney and heart , and to prevent and control pulmonary infection .