注射掺杂敌鼠的毒品导致凝血功能障碍4例临床分析

CLINICAL ANALYSIS OF 4 PATIENTS WITH DISTURBANCES OF BLOOD COAGULATION CAUSED BY INJECTION OF DRUG COMBINED DIPHACINONE

目的:总结注射掺杂敌鼠的毒品导致凝血功能障碍患者的临床特征、治疗方法及预后。方法:对2013年3月-6月新疆维吾尔自治区第六人民医院感染科收治的因注射毒品出现凝血功能异常的患者,结合流行病学史、起病情况、临床表现、实验室检查结果等,考虑主要诊断为"毒鼠药中毒致继发性维生素K缺乏症"的4例患者,采用补充维生素K1(40 mg·d-1-60 mg·d-1,静脉点滴)、使用糖皮质激素、输注红细胞悬液等治疗,观察患者出血情况,监测其凝血功能变化情况。结果:4例患者临床主要表现为大面积紫癜及凝血功能异常,经治疗后3例痊愈,1例因活动性出血死亡。结论:因一些贩毒者在制造毒品时将蟑螂药或老鼠药磨粉掺入,吸毒者在吸食毒品后会出现鼠药中毒的相关表现,如紫癜、血尿、关节痛、贫血、凝血功能异常等。对于这些病例应多加鉴别,以免误诊、漏诊,贻误治疗。

Objective：To summarize the clinical features,therapeutic methods and prognosis of 4 patients with disturbances of blood coagulation caused by injection drug use（IDU）.Methods：From March to June 2013,4 patients were admitted to Sixth People’s Hospital of Xinjiang Uygur Autonomous Region were enrolled. They were diagnosed ＂the secondary vitamin K deficiency caused by rodenticide poisoning＂according to epidemiological history,onset of disease,clinical manifestations and laboratory tests. We used vitamin K1（40-60 mg once per day）,glucocorticoid and transfusion therapy if necessary and monitored the changes of blood clotting and blood coagulation.Results： The major clinical manifestations were large area of purpura and disturbances of blood coagulation. Three cases were cured and one died due to cerebral hemorrhage.Conclusion：Drug addicts appears as rodenticide poisoning after taking drugs（such as purpura,coagulation dysfunction,hematuria, joint pain） because of some cockroaches or rodenticide were mixed with drugs. Identifying sporadic cases is necessary for the sake of avoiding misdiagnosis and mistreatment.