尿检百草枯对治疗和预后评估的价值

The value of the urine paraquat to evaluate prognosis

目的通过回顾分析我科2013年全年救治百草枯中毒病例,分析连二亚硫酸钠还原法尿检百草枯对疗效和预后评估的价值。方法:应用连二亚硫酸钠还原法检测收治的84例百草枯中毒患者尿液百草枯浓度,阳性为血灌指针,阴性者不予灌流。结果:84例百草枯中毒患者经血灌等治疗后90天随访,存活41例(48.8%),死亡43例(51.2%)。存活病例就诊即刻百草枯尿检检测结果明显轻于死亡病例,血灌次数也明显减少。结论:应用连二亚硫酸钠可迅速检测患者尿百草枯浓度,有助于评估患者血药浓度和中毒程度,指导是否给予血灌,尿百草枯持续阳性时间超过72 h,提示预后不良。

Objective Through retrospective analysis on the paraquat poisoning cases treated in our section during the whole year of 2013, assess the value that using sodium hydrosulfite reduction method to test paraquat concentration by urinalysis for curative effect and prognosis evaluation. Method：Check the concentration of paraquat in the urine of 84 paraquat poisoning patients who have been received and cured by sodium hydrosulfite reduction method, then take positive as an indicator of hemoperfusion and don’t use hemoperfusion for negative patients. Result：Conducted follow-up visits to the 84 paraquat poisoning patients who have had hemoperfusion and other treatments for 90 days, 41 of them survived （48.8%） and 43 were dead （51.2%）. Instant paraquat urinalysis result of the survived patients was obviously less than death cases, and the frequency of hemoperfusion also decreased obviously. Conclusion：By using sodium hydrosulfite, we can rapidly test paraquat concentration in patients＆#39; urine which is helpful to assess patients＆#39; haemoconcentration and poisoning level, and decide whether to use hemoperfusion or not. If urinalysis of paraquat keeps being positive for more than 72 hours, it can be an indicator of unfavourable prognosis.