摘要
目的总结急性口服84消毒液中毒患者的临床特征及治疗效果,以提高对该病的认识和诊治水平。方法于2022年1月,选取2016年3月至2021年8月中国人民解放军总医院第五医学中心全军中毒中心收治的25例急性口服84消毒液中毒住院患者为研究对象,对其一般情况、中毒原因、中毒时间、服毒量、临床表现、血常规及生化指标,诊治及预后情况进行回顾性分析。结果25例患者中男性4例,女性21例;年龄20~91岁,M(Q1,Q3)为38.7(27,46)岁;中毒时间(接触毒物至就诊时间)1~72 h,M(Q1,Q3)为10.5(3,11.5)h;住院天数1~20 d,M(Q1,Q3)为5.72(2,7)d;服毒量为40~500 ml,M(Q1,Q3)为219.6(100,330)ml。4例患者胸部CT提示双肺渗出性改变,1例透过度减低,1例胸腔积液。胃镜:2例胃体、胃窦部糜烂性炎症,1例食管溃疡、贲门溃疡,1腐蚀性胃炎,胃底溃疡,食管狭窄。腹平片:1例腹部部分肠管扩张、积气伴多发气液平面。并发I型呼吸衰竭1例,消化道出血6例,不完全肠梗阻1例。恶心呕吐19例,腹痛9例,咽痛、胸骨后烧灼痛各6例,咳嗽1例,乏力2例。结论急性口服84消毒液会对人体消化道、肺部产生不同程度的损伤,重者可出现消化道出血、肠梗阻、低氧血症等,治疗以保护消化道粘膜,控制急性炎症反应,保护肝肾等重要脏器功能等对症支持治疗为主。
Objective To summarize the clinical characteristics and treatment effect of patients with acute oral 84 disinfectant poisoning,so as to improve the understanding,diagnosis and treatment of the disease.Methods In January 2022,25 hospitalized patients with acute oral 84 disinfectant poisoning admitted to our department from March 2016 to August 2021 were selected as the research objects,and their general conditions,poisoning reasons,poisoning time,dose of poisoning,clinical manifestations,blood routine and biochemical indicators,diagnosis,treatment and prognosis were selected.Results A retrospective analysis was performed.Among the 25 patients,there were 4 males and 21 females,aged from 20 to 91 years,and M(Q1,Q3)was 38.7(27,46)years;The poisoning time(from exposure to poison to treatment)was 1~72 h,and M(Q1,Q3)was 10.5(3,11.5)h.The length of stay was 1~20 days,and M(Q1,Q3)was 5.72(2,7)days.The dose was 40-500 ml,and the M(Q1,Q3)was 219.6(100,330)ml.Chest CT showed exudative changes in both lungs in 4 patients,excessive decreased permeability in 1 case and pleural effusion in 1 case.Gastroscope showed 2 cases of erosive inflammation of gastric body and antrum,1 case of esophageal ulcer and cardiac ulcer,1 case of corrosive gastritis,gastric fundus ulcer and esophageal stenosis.Abdominal X-ray showed 1 case of abdominal intestinal dilatation and pneumatosis with multiple gas-liquid planes.There were 1 case of type I respiratory failure,6 cases of gastrointestinal bleeding and 1 case of incomplete intestinal obstruction.There were 19 cases of nausea and vomiting,9 cases of abdominal pain,6 cases of pharyngeal pain and 6 cases of retrosternal burning pain,1 case of cough and 2 cases of fatigue.Conclusion Acute oral 84 disinfectant will cause varying degrees of damage to the human digestive tract and lungs.In severe cases,gastrointestinal bleeding,intestinal obstruction,hypoxemia,etc,and even life-threatening,should be paid attention to clinically.The treatment is mainly symptomatic support treatment,such as protecting
作者
董建光
刘仲英
邱泽武
Dong Jianguang;Liu Zhongying;Qiu Zewu(Tianjin Central Hospital of Obstetrics and Gynecology,Tianjin 300100,China;Department of chemical injury treatment,Senior Department of Hepatology,Fifth Medical Center of the Chinese People's Liberation Army General Hospital,Poisoning Treatment Center of the Army,Beijing 100071,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2022年第12期935-938,共4页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
天津市医学重点学科(建设)项目(TJYXZDXK-043A)。
关键词
消毒液
中毒
肺损伤
化学性烧伤
肠梗阻
重症
Disinfectant
Poisoning
Injury of lungs
Chemical burn
Intestinal obstruction
Severe illness
