The value of toxicological analysis in acute poisoning patients with uncertain exposure histories:a retrospective and descriptive study from an institute of poisoning  

作　　者：Qifang Shi Gen Ba Zhenyu Xia Zhengsheng Mao Hao Sun Jinsong Zhang 

机构地区：[1]Institute of Poisoning,Nanjing Medical University,Nanjing 211100,China [2]Department of Emergency Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China [3]Department of Forensic Medicine,Nanjing Medical University,Nanjing 211166,China [4]The Key Laboratory of Modern Toxicology of Ministry of Education,Nanjing Medical University,Nanjing 211166,China

出　　处：《World Journal of Emergency Medicine》2024年第2期98-104,共7页世界急诊医学杂志（英文）

基　　金：supported by National Natural Science Foundation of China(82172184)。

摘　　要：BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

关 键 词：Acute poisoning Toxic exposure Toxicological analysis Clinical manifestation 

分 类 号：R595[医药卫生—内科学]