酚类灼伤所致酚中毒的临床研究

CLINICAL STUDY ON ACUTE PHENOL INTOXICATION FOLLOWED BY BURN

目的 探索酚类灼伤所致酚中毒的影响因素及酚中毒的临床特 点。方法 收集并筛选本院近２５年酚类灼伤的病例，重点对灼伤面积、部位、尿液颜色、 尿酚含量与酚中毒的关系进行统计学分析。结果 酚中毒及各脏器损害的发生 率和尿酚异常率，随灼伤面积增大而增高（Ｐ＜０．０５～０．０１），且在面颈部灼伤者 中发生率显著增高（Ｐ＜０．０５）。尿酚异常率与中毒发生率无明显关系。有２３例尿 酚量高于正常，而其中仅５例的尿色呈棕褐色，且均有明显溶血改变。酚中毒的 临床特点为肾脏是靶器官，中枢神经系统、溶血及心脏损害发生率高，且均为 早期表现，肝脏的急性影响相对较少。结论 导致酚中毒的影响因素主要是灼 伤面积、部位及创面的早期处理。酚类灼伤可导致多脏器功能障碍综合征，发 生时间大多在２４～４８ｈ内。

Objective To explore the affecting factors of phenols chemical burn lead to absorptive poisoning and its clinical characteristics. Methods To sort out clinical case of phenols burn of our hospital in recent twenty five years. The ralationship between on the intoxication and the burned area, site, urinary color, urinary phenol were analysed statistically. Results The rate of phenols poisoning and multiple organ damage, and the severity were increased with the burned scale (P<0.05～0.01). Moreover, It is much higher located in the face and neck(P<0.05). Regarding to the abnormality rate of urinary phenol which was in accordance with the above result. There was twenty three concentration of urinary phenol above normal level, just five of them urinary color was dark brown. Moreover, All of them had hemolysis change. The clinical feature pointed out kidneys was the target organ, the central nerve system, heart and hemolysis were early with the higher rate,while the liver damage was mild and late with the lower rate. Conclusion The main affecting factors of phenol poisoning were the scale, site and the early treatment of skin burn. Phenols burn could lead to multiple organ dysfunction syndrome and all occurred within 24～48 hours.