The Clinical Study Of 107 Patients With Acute Herbicide Poisoning

Objective:1.To summarize the epidemiological characteristics,clinical manifestations and diagnosis and treatment measures of patients with acute herbicide pesticide poisoning,and to provide the basis for the diagnosis and treatment norms of various acute herbicide poisoning;2.To explore the relationship between clinical indicators and prognosis of patients with acute herbicide pesticide poisoning,to effectively identify critical patients with poisoning at an early stage,and to provide a basis for clinical prevention and treatment of acute herbicide pesticide poisoning.Methods:1.The clinical data of 107 patients with acute herbicide pesticide poisoning treated in the emergency department of Shengjing Hospital affiliated to China Medical University from January 2015 to December 2019 were collected,and the hospitalized patients with complete data were screened for inclusion in the study.To the patient’s general information(gender,age),cause of poisoning,the amount of oral(or contact)herbicides,treatment in local hospital,determination of paraquat urine concentration,clinical manifestation,laboratory examination and imaging examination,whether blood perfusion treatment,length of hospital stay and discharge were analyzed retrospectively.2.The cases of the study according to the prognosis were divided into survival group and death group.General data and laboratory tests were compared between the two groups.The index of significant difference(P < 0.05)were put into the Logistic regression analysis,to analysis of the independent risk factors of death,and ROC curve to evaluate the prediction effectiveness of death.Spearman rank correlation was used to analyze the correlation between oral toxic dose and urine paraquat concentration and other indicators.Results:1.All 107 patients in this study were from Liaoning province.There were 58 male patients(54.21%)and 49 female patients(45.79%).The age range was 14-76 years,with an average age of(42.3±14.3)years.There were 60 cases of paraquat poisoning(56.08%),29 cases(27.10%)of diquat poisoning,6 cases(5.61%)of glyphosate poisoning,4 cases(3.74%)of glyphosate poisoning,and 8 cases(7.48%)of other herbicide poisoning.Leucocyte count,creatinine,alanine aminotransferase,trophin I,lactic acid and other laboratory indicators showed different degrees of increase in patients with different degrees of poisoning.26 patients(24.3%)died,including 8 patients with dioximide poisoning,16 with paraquat poisoning and 2 with glyphosate poisoning.81 patients(75.7%)survived.2.There were statistically significant differences between the two groups in oral dose of herbicide,time of visit to our hospital,gastric lavage,hemoperfusion,blood white blood cell count,creatinine,alanine aminotransferase,aspartate aminotransferase and lactic acid between the two groups(P < 0.05).Creatinine,oral dose of herbicide and lactic acid were independent risk factors for death from acute herbicide poisoning.For paraquat and diquat poisoning cases whose urine test for paraquat concentration were positive,oral herbicide dosage and creatinine,AST,lactic acid were positively correlated;urine paraquat concentration and blood leukocyte count,creatinine,ALT,AST,prothrombin time,D-dimer,lactic acid were positively correlated,and there was no significant correlation with troponin.Conclusion:Acute herbicide pesticide poisoning is a common disease in emergency department with a high mortality rate.In terms of poisoning types in this study,the number of paraquat poisoning cases showed a downward trend in the last three years,while diquat poisoning cases and other herbicide pesticide poisoning cases showed an upward trend.Creatinine is a better predictor of death.Attention should be paid to the patients with acute herbicide pesticide poisoning who have the corresponding risk factors,and treatment should be given accordingly.