百草枯中毒的急救其及预后影响因素分析

【目的】探讨百草枯中毒患者的治疗方法，并对影响其预后的因素进行分析。【方法】选择本院2011年8月至2013年5月收治住院的百草枯中毒患者34例的临床资料进行回顾性分析，研究对象分为生存组和死亡组，对比两组患者服毒剂量、首次呕吐时间、就诊时间、首次灌流时间及并发症对预后的影响，并测定血液灌流前后百草枯的浓度、超氧化物歧化酶（SOD）活力的变化。【结果】34例患者中10例生存（生存组），24例死亡（死亡组），病死率70．59％。血液灌流后患者血浆百草枯浓度明显降低而SOD活力明显增高，且与灌流前相比差异均有显著性（P＜0．05）；死亡组患者服毒剂量明显多于、首次呕吐时间明显早于存活组，且两组比较差异有显著性（P＜0．05）；死亡组就诊时间、首次灌流时间明显晚于存活组，且两组比较差异有显著性（P ＜0．05）；死亡组并发症发生率明显高于生存组，且两组比较差异有显著性（P ＜0．05）。【结论】对百草枯中毒患者要尽快地施行急救措施，多种因素会影响患者的预后，其中服毒剂量、SOD活力、百草枯的浓度、首次呕吐时间、就诊时间、首次灌流时间及并发症对预后影响非常关键。临床上应对百草枯中毒患者进行早期全方位治疗。

Treatment of Paraquat Poisoning and Analysis of the Influential Factors of Prognosis

Objective]To explore the treatment method of paraquat poisoning and analyze the influential factors of prognosis .Methods]Clinical data of 34 patients with paraquat poisoning admitted to our hospital from Aug .2011 to May 2013 were analyzed retrospectively .All patients were divided into survival group and death group .The effect of the poisoning concentration ,first vomiting time ,the visiting time ,first perfusion time and complications on the prognosis was compared between two groups .The changes of paraquat concentration and superoxide dismutase（SOD） before and after blood perfusion were measured .Results] Of 34 patients ,10 patients survived（survival group） and 24 patients died （death group） ,and the mortality rate was 70 .59% .Plasma levels of paraquat after blood perfusion were obviously decreased ,but SOD activity was obviously increased ,and there was significant difference between before and after blood perfusion （ P〈0 .05） .The poisoning dose in the death group was obviously more than that in the survival group ,but the first vomiting time in the death group was obviously earlier than that in the survival group ,and there was significant difference between two groups（ P〈0 .05） .The visiting time and first blood perfusion time in the death group were obviously later than those in the survival group ,and there was significant difference between two groups （ P〈0 .05） .The incidence of complications in the death groups is higher than that in the survival group ,and there was significant difference between two groups（ P〈0 .05） .Conclusion] Emergent first-aid measure should be performed as quickly as possible for patients with paraquat poisoning .Many factors can affect the prognosis . The poisoning doses ,SOD activity ,the concentration of paraquat ,first vomiting time ,the visiting time ,first blood perfusion time and complications are the very critical for the prognosis .Therefore ,early comprehensive treatment to deal with patients with paraquat poisoning should be