百草枯中毒死亡的临床病理分析

目的分析百草枯中毒死亡的临床及病理学特点，探讨百草枯中毒致肺纤维化的损伤机制。方法对2010年1月一2013年12月涉及百草枯中毒的3例死亡案例进行回顾性分析，观察对比急慢性百草枯中毒死亡的临床特点及病理学改变。结果百草枯中毒的临床及病理表现主要是以肺为靶器官的多器官损伤，急性中毒死亡者肺损伤主要为肺水肿及肺透明膜形成，慢性中毒死亡者肺损伤主要为肺透明膜形成及广泛肺间质纤维化。结论临床上应加深百草枯中毒表现及损伤机制的认识以对患者进行早期诊治。而法医学鉴定应结合案情、临床资料、毒物分析及解剖结果进行综合分析而得出正确的鉴定结论。

Clinical Pathological Analysis of Death from Paraquat Poisoning

Objective To analyze the clinical and pathologic features of paraquat poisoning, discuss the damage mechanism of pulmonary fibrosis caused by paraquat poisoning. Methods We retrospectively analyzed the paraquat poisoning- related cases collected in recent years from January 2010 to December 2013, and compared the clinical features and pathologic changes between acute and chronic paraquat poisoning cases. Results The main clinical and pathologic manifestation of paraquat poisoning was multiple organ damage, especially with lung as its target organ. In acute poisoning deaths, the lung injury was characterized by the pulmonary edema and formation of lung transparent membrane; In chronic poisoning deaths, the injury was characterized by the formation of lung transparent membrane and pulmonary fibrosis. Condusions In order to make an earlier diagnosis in clinical cases, we should strengthen the cognition of clinical manifestations and damage mechanism of paraquat poisoning. To obtain an accurate conclusion in forensic medicine appraisal, we should draw a comprehensive analysis of the forensic case, the clinical data, the toxicological analysis and the autopsical results.