【摘要】 目的探讨急性百草枯中毒患者血清电解质改变的临床意义。方法选取急性百草枯中毒患者104例,以住院期间死亡为观察终点,存活>30d为治愈,分为治愈组和死亡组。比较2组患者入院第1、4天的血钾、血钙、血钠及二氧化碳结合力(carbondioxide combining power,CO2CP)水平;于入院第1,4,7,10,13,16,30天动态观察治愈组血钾、血钙、血钠、CO2CP水平变化趋势。结果入院第1天,死亡组CO2CP明显低于治愈组(P<0.05),2组血钾、血钙、血钠水平差异均无统计学意义(P>0.05)。入院第4天,死亡组只存活28例,2组血钾、血钙、血钠、CO2CP水平均明显低于入院第1天,死亡组血钾、血钙、CO2CP水平明显低于治愈组(P<0.05),2组血钠水平差异无统计学意义(P>0.05)。治愈组随时间延长,血钾、血钙、CO2CP水平呈先降低后升高的趋势,第16天血钾水平高于第4天和第7天,第4,7,10,13,16天血钙水平低于第1天,第6天血钙低于第4天,第10天CO2CP水平高于第4天,第13,16天CO2CP水平高于第1,4,7,10天(P<0.05);不同时间点血钠水平差异无统计学意义(P>0.05)。结论百草枯造成的应激状态、炎症反应及多器官损伤可影响机体电解质水平,应在治疗中给予足够重视。更多还原

【Abstract】 Objective To explore the clinical significance of changes in serum electrolytes levels in patients with acute paraquat poisoning.Methods A total of 104 patients with acute paraquat poisoning were selected.Death during hospitalization was used as the end point of observation,while the>30 days survival was treated as cured.In this way,patients were divided into death group and cure group.The levels of serum potassium,serum calcium,serum sodium and carbondioxide combining power（CO₂ CP）in the first and fourth days of hospitalization were compared between the two groups.The changes of serum potassium,serum calcium,serum and CO₂ CP levels in the cure group were observed dynamically on the 1 st,4 th,7 th,10 th,13 th,16 th and 30 th day after admission.Results On the first day of admission,the CO₂ CP of the death group was significantly lower than that of the cure group（P<0.05）.There was no significant difference in serum potassium,serum calcium and serum sodium levels between the two groups（P>0.05）.On the fourth day of admission,only 28 patients survived in the death group.The levels of serum potassium,serum calcium,serum sodium and CO₂ CP in the two groups were significantly lower than those on the first day of admission.The levels of serum potassium,serum calcium and CO₂ CP in the death group were significantly lower than those in the cure group（P<0.05）.There was no significant difference in serum sodium levels between the two groups（P>0.05）.For the patients in the cure group,the levels of serum potassium,serum calcium and CO₂ CP were decreased first and then increased over time.On the 16 th day,the serum potassium level was higher than that on the 4 th and 7 th day.On the 4 th,7 th,10 th,13 th and 16 th day,the serum calcium level was lower than the first day,and on the 6 th day,the serum calcium was lower than the 4 th day.On the 10 th day,the CO₂ CP level was higher than the 4 th day,and the CO₂ CP level was higher than the 1 st,4 th,7 th and 10 th days on the 13 th and 16 th day（P<0.05）.There was no significant difference in serum sodium levels in different time points（P>0.05）.Conclusion The stress state,inflammatory response and multiple organ damage caused by paraquat can affect the electrolyte level of the body and reduce the level of serum electrolytes,which should be given enough attention in the treatment.更多还原