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目的:城市中杀鼠药中毒容易被临床医师忽视,其引起消化道出血也极易误诊和漏诊,本文分析抗凝血杀鼠药中毒至消化道出血患者的临床表现和诊治方法。方法:回顾性分析2010年1月至2013年8月间我院收治的25例杀鼠药中毒并出现消化道出血病例,对其临床表现和诊治方法进行分析总结,病例均以维生素K1抗凝血方法进行治疗,并比较分析治疗前后患者的凝血酶原时间(PT)、国际正常化比率(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和出血时间(TT)等出凝血指标进行检测,并进行比较分析。结果:25例因抗凝血杀鼠药物中毒并导致消化道出血患者经维生素K1等抗凝血方法治疗患者全部治愈,消化道出血停止,凝血指标恢复正常,治疗前后患者的凝血指标存在明显差异(P<0.05)。结论:抗凝血法对杀鼠药中毒导致消化道出血进行治疗的临床效果显著,值得推广。
Aims: It is easy for clinicians to neglect the poisoning of mice in the city. It is also very easy to misdiagnosis and missed diagnosis of gastrointestinal bleeding. This article analyzes the clinical manifestations and diagnosis and treatment of patients with anticoagulant and rodenticidal poisoning to gastrointestinal bleeding. Methods: A retrospective analysis of 25 cases of rodenticide poisoning and gastrointestinal bleeding occurred in our hospital from January 2010 to August 2013 was conducted. The clinical manifestations and diagnosis and treatment methods were analyzed and summarized. All cases were treated with vitamin K1 anticoagulation (PT), International Normalization Ratio (INR), APTT, FIB and TT in patients before and after treatment were compared and analyzed. Out of coagulation indicators were detected, and comparative analysis. Results: 25 cases of anticoagulant rodenticide poisoning and gastrointestinal bleeding caused by vitamin K1 and other anticoagulant treatment of patients were cured, gastrointestinal bleeding stopped, the coagulation index returned to normal, before and after treatment in patients with coagulation parameters were significantly different (P <0.05). Conclusion: The anticoagulant therapy has a significant clinical effect on the treatment of gastrointestinal bleeding caused by the poisoning of rats and is worth promoting.