急性百草枯中毒患者生存状况的相关因素研究

The analysis on the related factors of living condition for the patients with acute paraquatpoisoning

目的探讨急性百草枯（PQ）中毒患者生存状况的相关因素,为临床对PQ中毒的诊断、治疗及预后提供依据。方法选取2008年1月-2014年1月收治的64例PQ中毒患者,并根据随访结果分为死亡组和存活组。结果患者APACHEⅡ及SOFA评分比较,死亡组患者的评分均显著高于存活组（P〈0.05）。PQ摄入量、血浆PQ浓度、洗胃时间、首次呕吐时间、白细胞计数、尿蛋白、尿白细胞计数、空腹血糖、血清淀粉酶、AST、ALT、胆红素、HCO3^-、Lac、磷酸激酶同工酶、磷酸激酶、APACHEⅡ评分、SOFA评分与预后呈负相关;呕吐次数、催吐人数比例、血液净化时间、口腔黏膜炎严重程度、中性粒细胞计数、血清K^＋、血清肌酐、PCO2、BE、VC MAX、FVC、FEV1、胸部CT正常比例和餐后PQ中毒与预后呈正相关。结论急性PQ中毒预后与多因素相关,探讨急性PQ中毒患者生存状况的相关因素,对判定PQ中毒的预后、指导治疗、提高生存率具有重大的临床指导意义。

Objective To explore the related factors of acute paraquat poisoning survival of patients for clinical diagnosis of PQ poisoning, treatment and prognosis basis. Methods 64 cases of PQ poisoning were selected from January 2008 to January 2014 of our hospital, according to the follow-up results are divided into death group and survival group.Results Patients APACHE Ⅱ and SOFA scores, scores of dead patients were significantly higher than the survival group（P 〈0.05）. PQ intake, plasma concentrations of PQ, time of gastric lavage, emesis first time, white blood cell count, urine protein, urine white blood cell count, fasting blood glucose, serum amylase, AST, ALT, bilirubin, HCO3^-, Lac, phosphate kinase workers enzyme, kinase, APACHE Ⅱ score, SOFA score and the prognosis were negatively correlated; frequency of vomiting, vomiting proportion, blood purification time, oral mucositis severity, neutrophil count, serum K^＋, serum creatinine,PCO2, BE, VC MAX, FVC, FEV1, chest CT normal ratio and postprandial PQ poisoning and prognosis were positively correlated. Conclusion The prognosis of acute PQ intoxication and multiple factors related to acute PQ intoxication living condition of the patient-related factors, prognosis PQ poisoning, guide treatment and improve survival of great clinical significance.