院前解救方法对15例急性百草枯中毒者预后的影响

Effects of Pre-hospital Rescue Measures on the Prognosis of 15 Acute Paraquat Poisoning Patients

目的:研究院前解救方法对急性百草枯中毒者预后的影响,证实黏土水混悬液用于院前解救的可行性。方法:采用回顾性分组对照研究,选取2013-2015年广西医科大学第一附属医院救治的15例急性百草枯中毒者,按照预后情况分为死亡组(n=9)和存活组(n=6),收集所有中毒者的性别、年龄、百草枯摄入量、服毒后至送入院的间隔时间、院前采取的解救方法(饮水催吐、口服黏土水混悬液催吐、手指抠喉催吐)、入院后30 min内的百草枯血药浓度,计算百草枯中毒严重指数(SIPP1=入院时首次检测所得百草枯的血浆浓度×服毒后至入院的间隔时间;SIPP2=百草枯摄入量×服毒后至入院的间隔时间),并进行比较。结果:与死亡组比较,存活组中毒者的性别、年龄、百草枯摄入量、服毒后至送入院的间隔时间和SIPP2差异均无统计学意义(P>0.05),但院前采取过解救方法的人数比例更高(P<0.05),入院后30 min内的百草枯血药浓度和SIPP1均更低(P<0.05)。存活组中毒者院前采取的解救方法包括口服黏土水混悬液催吐3例、饮水催吐1例、手指抠喉催吐1例;死亡组中毒者中有2例院前采取了饮水催吐。结论:对急性百草枯中毒者进行及时的院前解救能显著提高其预后效果,院前解救方法中口服黏土水混悬液催吐效果较好。

OBJECTIVE：To study the effects of pre-hospital rescue measures on the prognosis of acute paraquat poisoning patients,confirm the feasibility of clay water suspension for pre-hospital rescue. METHODS：In retrospective controlled study,15 patients with acute paraquat poisoning were selected from the First Affiliated Hospital of Guangxi Medical University during 2013-2015,and then divided into death group（n=9）and survival group（n=6）according to prognosis situation. The information of poisoning patients were collected,involving gender,age,paraquat intake,the time from patients taking paraquat to admission to hospital,pre-hospital resuce measures（drinking water to induce vomiting,oral clay water suspension to induce vomiting,finger spitting to induce vomiting）,blood concentration of paraquat within 30 min after admission. The index of paraquat poisoning severity（SIPP1=blood concentration of paraquat at admission×interval between poisoning and admission;SIPP2=paraquat intake×interval between poisoning and admission）were calculated and compared. RESULTS：Compared with death group,there was no statistical significance in gender,age,paraquat intake,interval between poisoning and admission or SIPP2 of survival group（P〉0.05）;the number of patients receiving pre-hospital rescue measure was higher（P〈0.05）;the blood concentration of paraquat and SIPP1 were lower significantly within 30 min after admission（P〈0.05）. Pre-hospital rescue measures of survival group included giving clay suspension solution orally to induce vomiting（3 cases）,drinking water to induce vomiting（one case）and scratching the throat with finger to induce vomiting（one case）. In death group,2 patients drank water to induce vomiting before admission.CONCLUSIONS：Timely pre-hospital rescue measure can improve the prognosis effects of acute paraquat poisoning patients.Among pre-hospital rescue measure,it is a good method to give clay water suspension orally to induce vomiting.