急性百草枯中毒的临床分型与预后分析  

Analysis of clinical classification and outcome of patients with acute paraquat poisoning

作　　者：张炜[1] 孙海晨[1] 邵旦兵[1] 唐文杰[1] 刘红梅[1] 李伟[1] 许宝华[1] 聂时南[1] 

机构地区：[1]南京大学医学院,南京军区南京总医院急救医学科,南京210002

出　　处：《中华急诊医学杂志》2010年第4期357-360,共4页Chinese Journal of Emergency Medicine

基　　金：基金项目：南京晕区122工程重点培养对象资助项目（JQZD200905）;南京军区南京总医院青年基金课题（2009Q036）

摘　　要：目的 探讨急性百草枯中毒的临床分型及与预后的关系，以期建立一种快速简便的分型方法，加深对百草枯中毒的认知。方法对南京军区南京总医院急救医学科2005年1月至2009年9月收治的43例百草枯急性中毒患者的资料进行回顾分析后，以受累脏器及损害程度作为分型标准，在就诊24h内进行临床分型，通过Fisher精确概率法探讨各分型与预后的关系。结果43例百草枯急性中毒患者中有轻度中毒6例，无死亡病例，中度中毒20例，死亡9例（死亡率45．0％），重度中毒17例，死亡16例（死亡率94．1％）；各型的死亡率不全相等（P〈0．01）；轻度与中度死亡率差异无统计学意义（P=0．063），轻度与重度死亡率差异有统计学意义（P〈0．01），中度与真度死亡率差异有统计学意义（P=0．002）。结论急性百草枯中毒的机制及临床特征很复杂，本临床分型方法能较好的区分各型疾病。Objective To study correlation between the clinical classification and outcome of acute paraquat poisoning. Method A total of 43 patients subjected to acute paraquat poisoning admitted from January 2005 to September 2009 were retrospectively studied. A clinical classification was made based on the criteria of damage severity of involved organs in these patients within 24 hours after admission, and the correlation between classification and outcome of patients was analyzed with Fisher＇ s exact probabilities analysis. Results Thr clinical types were classified within 24 hours after admission： mild type （n = 6）, all patients survived; moderate type （n = 20） ,nine patients died （45.0% mortality） ,and severe type （ n = 17）, 16 patients died （94.1% mortality）. The Fisher＇s exact probabilities analysis demonstrated significant differences in mortality among different clinical types （ exact P 〈 0.01 ）. There was no difference in mortality between mild and moderate type （exact P = 0. 063）. The mortality rate of mild type was lower than that of the severe type （ exact P = 0.01 ）, and the mortality rate of moderate type was lower than that of the severe type （exact P = 0. 002）. Conclusions This method of classification can be used to distinguish various degrees of intoxication, and has a correlation with prognosis of patients.

关 键 词：百草枯中毒 临床分型 预后 轻度中毒 中度中毒 重度中毒 脏器功能障碍 治疗 

分 类 号：R595.4[医药卫生—内科学]