不同综合治疗急性百草枯中毒的疗效观察及预后分析  

作　　者：罗丽英[1] 沈晔[1] 方玲翠[1] 

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院),310014

出　　处：《浙江临床医学》2022年第9期1329-1330,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨不同综合治疗策略对急性百草枯中毒患者预后的影响.方法回顾性分析2010年2月至2021年4月148例百草枯中毒患者的临床资料,按照不同治疗方案分成甲泼尼龙+环磷酰胺联合治疗组和甲泼尼龙治疗组.比较两组患者死亡率、存活时间、和死亡原因.结果148例患者中存活54例,死亡94例,病死率63.5%.甲泼尼龙+环磷酰胺组病死率为58.2%,甲泼尼龙组病死率为67.9%,两组比较差异有统计学意义(P<0.05),两组患者平均存活时间差异有统计学意义(P<0.05).造成患者死亡的第一位原因为呼吸衰竭.结论百草枯中毒无特效治疗药物,临床综合治疗仍为最重要的治疗方法.大剂量甲泼尼龙联合环磷酰胺的冲击疗法及甲泼尼龙递减维持治疗的早期应用,能有效减轻百草枯中毒患者重要脏器的损伤程度,减轻肺损伤,降低病死率.Objective To explore the effect of comprehensive treatment strategy on the prognosis of patients with acute paraquat poisoning.MethodsThe clinical data of 148 patients with paraquat poisoning from February 2010 to April 2021 were retrospectively analyzed.The patients were divided into methylprednisolone+cyclophosphamide group and methylprednisolone group according to different treatment regimens.Mortality,survival time,and causes of death were compared between the two groups.ResultsAmong the 148 patients with paraquat poisoning,54 survived and 94 died,with a mortality rate of 63.5%.On admission,the main clinical features of the two groups were basically the same.The mortality rate in the methylprednisolone+cyclophosphamide group was 58.2%.And the methylprednisolone group was 67.9%.There was significant difference between the two groups(P<0.05).The mean survival time of patients in both groups was(P<0.05),and the comparison between the two groups was statistically significant.Respiratory failure was the leading cause of death in both groups.ConclusionThere is no specific antidote to paraquat poisoning,clinical comprehensive treatment is particularly important.The therapy of high-dose pulse methylprednisolone and cyclophosphamide unite decreasing maintenance of methylprednisolone in patients of paraquat poisoning can reduce the viscera damage degree,lung injury and the case fatality rate.

关 键 词：百草枯中毒 呼吸衰竭 甲泼尼龙 环磷酰胺 

分 类 号：R595.4[医药卫生—内科学]