缺乏病史的儿童溴敌隆中毒1例分析并文献复习

Analysis of a case of Bromadiolone poisoning in children with no medical history and literature review

溴敌隆属于长效抗凝血杀鼠剂,慢性高毒。中毒潜伏期长,临床表现多样、不典型,有明确溴敌隆暴露史者,诊断不难。但部分中毒者病史隐匿,尤其儿童,常常遗漏或者隐瞒病史,容易造成漏诊、误诊,从而延误治疗,甚至危及生命。本文回顾性分析1例漏诊1月余的幼儿溴敌隆中毒的临床资料及诊治过程,提示对于不明原因出血、凝血功能异常的儿童,最好常规完善血液灭鼠药检查。同时进行文献复习,以期引起临床重视,减少漏诊误诊。

Bromadiolone is a long-acting anticoagulant rodenticide,chronic and highly toxic.The incubation period of poisoning is long,the clinical manifestations are diverse and atypical,and the diagnosis is not difficult for patients with clear exposure history of Bromadiolone.However,some people who have been poisoned are concealing their medical history,especially children,who often omit or conceal their medical history,which may easily lead to missed diagnosis and misdiagnosis,thus delaying treatment and even endangering their lives.The clinical data,diagnosis and treatment of a child with bromadiolone poisoning missed for more than 1 month were retrospectively analyzed.It is suggested that for children with unexplained bleeding and abnormal coagulation function,it is best to improve the routine blood rodenticide examination.At the same time,literature review was carried out in order to attract clinical attention and reduce missed diagnosis and misdiagnosis.