102例急性苯的氨基、硝基化合物中毒临床分析

Clinical analysis on 102 cases on acute aromatic amino and nitro-compounds poisoning

目的探讨急性苯的氨基、硝基化合物中毒的临床特点。方法收集1995—2012年收治的102例职业性苯的氨基、硝基化合物中毒患者的临床资料,对其临床特点进行回顾性分析。结果 102例患者中男性93例,女性9例;年龄中位数(M)为38(17~61)岁;接触反应5例,轻、中、重度中毒分别为69、21、7例;潜伏期M为2 h(10 min^14 h)。99例患者(占97.06%)出现紫绀,21例患者(占20.59%)合并溶血性贫血,高铁血红蛋白(MHb)水平与临床诊断分级符合率为58.62%。17例患者(占16.67%)出现膀胱刺激症状。102例患者经积极治疗后101例痊愈,1例因多脏器功能衰竭而死亡,治愈率为99.02%;住院时间M为7(1~55)d。结论急性苯的氨基、硝基化合物中毒临床以血液系统损害为主要表现,可伴有肝脏、肾脏损害,严重者可导致死亡,实验室测得MHb水平与病情并不完全相符,应用特效药亚甲蓝治疗效果好。

Objective To investigate the clinical features of acute aromatic amino and nitro-compounds poisoning . Methods The clinical data of 102 cases of occupational aromatic amino and nitro-compounds poisoning were retrospectively analyzed.Results It consisted of 93 male and 9 female, the median of ages was 38 （from 17 to 61）years.Five cases were diagnosed contact reaction , the number of which was diagnosed as mild , moderate and severe poisoning were 69, 21, 7.The median of incubation period was 2 hours （from 10 minutes to 14 hours）.Ninety-nine cases were showed cyanosis , 17 cases （16.67%） with bladder irritation, while 21 cases （20.59%） merged with hemolytic anemia.The compliance rate of MHb concentration and clinical diagnostic classification was 58.62%.Treatment outcomes were well , of which 101 were cured, 1 case died of multiple organ failure , the cure rate was 99.02%, the median of average hospital time was 7 days （from 1 to 55 days）.Conclusion Hematopoietic system is the target organ of acute aromatic amino and nitro-compounds poisoning, may be accompanied by liver or kidney damage .Severe cases may lead to death .The blood methemoglobin con-centrations not entirely consistent with the degree of patient＇s condition, after using the miracle drug-methylene blue, the disease will soon get better .