毒鼠药中毒致凝血异常19例临床分析  

Clinical analysis of 19 patients about disturbances of blood coagulation caused by ratsbane toxication

作　　者：王蕾[1] 郭新红[1] 江明[1] 曲建华[1] 段显琳[1] 王新有[1] 

机构地区：[1]新疆医科大学第一附属医院血液科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2013年第7期962-964,969,共4页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(20100110)

摘　　要：目的总结鼠毒药中毒导致凝血异常的的临床特征、治疗方法及结果。方法对2009年1月-2012年1月新疆医科大学第一附属医院门诊及住院患者中,根据病史及实验室检查,考虑诊断为"毒鼠药中毒致继发性维生素K缺乏症"的19例患者,采用维生素K140～60mg,加入5%～10%葡萄糖溶液内作静点滴注射,每日1次。病重者增加维生素K1用量,必要时补充凝血因子或输注维生素C和氢可,对中、重度贫血,组织缺氧症状重者输注红细胞悬液。观察患者凝血功能及出血症状的变化情况。好转后改维生素K110～20mg肌注,每日1～2次,治疗2～6个月,随访半年。结果 19例均有不同程度的出血及凝血异常,给予维生素K1等治疗后19例全部治愈。结论抗凝血性杀鼠剂中毒以出血症状为主要表现,但对散发病例应注意鉴别,以免误诊,用维生素K1治疗是特效解毒药。Objective To summarize the clinical features, therapeutic methods and results about disturb-ances of blood coagulation caused by ratsbane toxication. Methods Choosing 19 subjects from those out-patients and inpatients from January 2009 to January 2012 who were diagnosed ＂the secondary vitamin K deficiency caused by ratsbane toxication＂ according to medical history and laboratory examination, we used vitamin K1 40-60rag added in 5%-10% glucose solution to drip infusion once per day. Seriously-ill pa-tients took more vitamin K1 and make up blood coagulation factors if necessary or infused vitamin C and hydrocortisone prorenata. Erythrocyte suspension was infused into those who had a moderate or severe a-nemia and histanoxia. We monitored the changes of patients＂ blood clotting and bleeding symptoms. After they felt better, we used vitamin K1 10=20 mg intramuscular injecting to those patients once or twice per day for 2 to 6 months. Follow-up visit lasted for half a year. Results All of the 19 patients had different extent of bleeding and clotting abnormalities. They were all cured after being given vitamin K1 during treatment. Conclusion Bleeding is the main symptom of the ratsbane toxication. Identifying sporadic ca-ses should be paid attention to for the sake of avoiding misdiagnosis. The therapy with vitamin K1 is a spe-cific antidote.

关 键 词：毒鼠药中毒 凝血异常 维生素K1 

分 类 号：R559[医药卫生—血液循环系统疾病]