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目的分析沧州地区急性百草枯中毒的流行病学特征及通过白细胞总数和中性粒细胞绝对值变化判断百草枯中毒患者预后的意义。方法以2008年10月—2016年9月沧州市人民医院急救中心收治的432例急性百草枯中毒患者为研究对象,对其年龄、职业、中毒途径、中毒原因、中毒剂量、中毒距就诊时间、转归等进行统计分析。再将其中经口途径中毒且转归明确的363例患者列为观察组,按转归不同细分为3组:存活组、3 d内死亡组、3 d后死亡组,统计分析各组患者入院即刻和入院后第2、3、5、7 d外周血白细胞总数和中性粒细胞绝对值。结果全部432例患者中,男女比1∶1.15(201∶231),年龄以20~50岁为主(71.99%),主要为农民(68.98%),口服途径占85.42%,中毒原因以自杀居多(60.65%);治愈或好转患者最多,占48.84%,未愈或死亡患者占46.06%,转归为其他占5.09%。363例观察组患者中,3 d内死亡组和3 d后死亡组患者入院即刻和入院后第2、3、5、7 d外周血白细胞总数和中性粒细胞绝对值高于存活组,差异有统计学意义(均P<0.05);3 d内死亡组入院即刻和入院后第2天外周血白细胞总数和中性粒细胞绝对值高于3 d后死亡组,差异有统计学意义(均P<0.05);入院后第3 d,3 d内死亡组和3 d后死亡组外周血白细胞总数和中性粒细胞绝对值相比较,差异无统计学意义(P>0.05)。结论急性百草枯中毒死亡率高,早期救治是关键,外周血白细胞总数和中性粒细胞绝对值变化对判断百草枯中毒患者预后有重要意义。
Objective To analyze the epidemiological characteristics of acute paraquat poisoning in Cangzhou and to evaluate the prognosis of patients with paraquat poisoning by changing the total number of leukocytes and neutrophils. Methods A total of 432 cases of acute paraquat poisoning patients admitted to Emergency Center of Cangzhou People’s Hospital from October 2008 to September 2016 were selected as research objects. Their age, occupation, route of poisoning, cause of poisoning, poisoning dose, Results and other statistical analysis. 363 patients with orally poisoned and clear outcome were further divided into three groups according to the different prognosis: survival group, death within 3 days, death after 3 days, statistical analysis of each group of patients The total number of leukocytes and neutrophils on the 2nd, 3rd, 5th, 7th day after hospital admission and immediately after admission. Results Among all the 432 patients, the ratio of male to female was 1:1.15 (201: 231), and the age was mainly from 20 to 50 years old (71.99%), mainly from peasants (68.98%), oral administration accounted for 85.42% (60.65%). The patients who cured or improved were the most, accounting for 48.84%, those who did not heal or died accounted for 46.06% and the others were 5.09%. Among the 363 observation group, the total number of leukocytes and neutrophils on the 3rd, 3rd, 5th and 7th days after death in the 3-day group and the post-3-day death group were significantly higher than those in the surviving group (Both P <0.05). The number of peripheral blood leukocytes and neutrophils in the death group within 3 days immediately after admission and after 2 days were higher than those in the dead group after 3 days, both of which were statistically significant P <0.05). There was no significant difference in the total number of peripheral white blood cells and neutrophils between the dead group on the 3rd and 3rd d after admission and the death after 3 d (P> 0.05). Conclusion The mortality of acute paraquat poisoning is high, and the early treatment is the key. The change of the total number of peripheral white blood cells and neutrophils is of great significance for judging the prognosis of paraquat poisoning patients.