急性百草枯中毒患者血清电解质改变的研究  

Study on the changes of serum electrolytes levels in patients with acute paraquat poisoning

作　　者：孟兆华[1] 靳英利 朱铁英 田英平[1] MENG Zhao-hua;JIN Ying-li;ZHU Tie-ying;TIAN Ying-ping(Department of Emergency,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院急诊科,河北石家庄050000

出　　处：《河北医科大学学报》2018年第11期1262-1265,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20160110)

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。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（CO 2CP） in the first and fourth days of hospitalization were compared between the two groups. The changes of serum potassium, serum calcium, serum and CO 2CP 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 CO 2CP 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 CO 2CP in the two groups were significantly lower than those on the first day of admission. The levels of serum potassium, serum calcium and CO 2CP 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 CO 2CP 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 CO 2CP level was higher than the 4 th day, and the CO 2CP level was higher than the 1 st, 4

关 键 词：中毒 百草枯 电解质 

分 类 号：R595.9[医药卫生—内科学]