【摘要】 目的通过分析百草枯中毒患者的预后及其相关影响因素,明确决定预后的重要因素,为急性百草枯中毒患者的病情评估、预后判断及治疗方案制定提供参考依据,并为探索更加有效的治疗手段建立基础。方法纳入2010年6月～2011年11月期间因口服百草枯中毒就诊于某院急诊科的117例患者,入院时检测治疗前血浆百草枯浓度并给予洗胃、导泻、血液灌流、免疫抑制剂和抗氧化等治疗。采用Kaplan-Meirer单因素分析及Cox回归模型分析来判断年龄、口服剂量、服毒至洗胃时间、服毒至血液灌流时间、血液灌流次数、治疗前血中百草枯浓度等6项相关因素与患者预后的关系。结果 117例患者随访1月后有54人死亡,死亡率46.15%;死亡组与存活组两组间除口服百草枯剂量、治疗前血浆百草枯浓度以及血液灌流次数的差异有统计学意义(P﹤0.05)外,在年龄、服毒至洗胃时间、服毒至血液灌流时间上差异均无统计学意义(P﹥0.05);采用生存分析发现服毒剂量和血浆百草枯浓度两项指标对患者预后有显著影响,差异有统计学意义(P﹤0.05)。结论百草枯口服剂量及血浆百草枯浓度是决定百草枯中毒患者是否能够存活的独立预后因素,而其他4项指标不能改变百草枯中毒患者的预后。更多还原

【Abstract】 OBJECTIVE To study the associations between prognosis and its related clinical factors in patients with acute paraquat(PQ) poisoning,so as to facilitate the evaluation of clinical status and prognosis,as well as the formulation of appropriate therapeutic methods.METHODS 117 patients with acute PQ intoxication were included in this study from June 2010 to November 2011.Pre-therapeutic plasma PQ concentration was tested on admission and a standardized therapeutic regimen including gastric lavage,antioxidants and emergency haemoperfusion was given on all subjects.Cox regression model and KaplanMeier survival analysis were used to investigate the associations between prognosis and related factors including age,oral ingestion volume,time in taking poisoning to gastric lavage,time from poisoning to hemoperfusion,times of hemoperfusion and the plasma concentration of paraquat before treatment.RESULTS After 1 month of follow-up,54 out of 117 patients died(mortality rate 46.15%).There was significant difference in the ingestion volume,plasma PQ concentration and times of hemoperfusion between death group and survival group(P﹤0.05),while no statistical difference was found in age,time from ingestion to gastric lavage,time from ingestion to hemoperfusion or times of hemoperfusion.By survival analysis,we found that oral dose and pre-therapeutic plasma PQ concentration would significantly affect the survival of the patients.CONCLUSION The ingestion volume of PQ and the plasma PQ concentration prior to treatment were the independent factors associated with of the prognosis of patients and can directly related to the survival.更多还原