| Objective: Paraquat(PQ)has been widely used in modern agriculture and garden weeding in 1962 because of its general non selectivity and contact toxicity.At the same time,the case reports of paraquat poisoning are gradually appearing because of the high mortality after poisoning,but the treatment effect is poor.The research of treatment methods has gradually become a hot spot.Paraquat pesticides have strong toxicity to both humans and animals.Acute poisoning can be caused by inhalation of respiratory tract,skin contact and oral administration,Respiratory failure caused by multiple organ dysfunction and pulmonary fibrosis,and the mortality rate is high.This study combined with the design and research project of the diagnosis and treatment of paraquat poisoning in recent years,and analyzed the clinical diagnosis and treatment data of paraquat poisoning from 2010 to 2016 in our hospital,which can explore the clinical efficacy and prognosis of ambroxol combined with large dose of dexamethasone in the treatment of paraquat poisoning,in order to further improve the level of treatment for paraquat pesticide poisoning.Methods: This study was a prospective study on the clinical data of 87 cases of paraquat poisoning in the emergency department of the people's Hospital of Dingtao District,Heze,from January 2010 to December 2016,which were randomly divided into 2groups,group A(large dose of dexamethasone routine treatment group),43 people,group B(ambroxol HCl combined with large dose of dexamethasone): 44 people.Each group was divided into mild poisoning,moderate severe poisoning and explosive poisoning according to the oral dose.The survival rate after twenty-eighth days of PQ poisoning was observed,and the values of Cr,BUN,ALT and AST were measured at the immediate,third,seventh,and fourteenth days of hospitalization,to observe the changes of liver and kidney function after paraquat poisoning;And the blood gas analysis was dynamicallymeasured every day and after treatment,and the lung HRCT was examined at the immediate,third,seventh,fourteenth,twenty-first,and twenty-eighth days of admission to the hospital.Observation of lung oxygenation and respiratory function improvement,The scores were compared between the two groups,and the effect of ambroxol hydrochloride combined with high-dose dexamethasone was evaluated.Results: Organ failure syndrome(Multiple organ dysfunction syndrome,MODS)and respiratory failure caused by pulmonary fibrosis are the main causes of death due to acute paraquat poisoning.Twenty-eighth days after acute poisoning,the survival rate of the B group was significantly higher than that in the A group,with significant difference in the liver and kidney damage at the third,seventh,fourteenth and twenty-first days after the treatment,and the blood gas analysis index of group A and B at third days,seventh days,fourteenth days and twenty-first days after the treatment.The PaO2 value and PaO2/Fi O2 value of group B were higher than that of group A?The HRCT score of patients in early stage showed that the score of group B was lower than that of group A,and the difference between the two groups was statistically significant.Conclusion:Ambroxol hydrochloride combined with large dose of dexamethasone in the treatment of acute paraquat poisoning compared with the use of large dose of dexamethasone routine treatment group can significantly prolong the survival time of the patients,improve the survival rate and cure rate of the poisoned patients,reduce the mortality of the oral paraquat poisoning,reduce the injury of liver and kidney caused by PQ poisoning,and early use ambroxol hydrochloride combined with the treatment.The treatment of paraquat poisoning by large dose of dexamethasone can reduce the inflammatory exudation of the lung and slow the process of pulmonary fibrosis.It has shown that ambroxol HCl combined with large dose of dexamethasone has a good effect in the treatment of acute paraquat poisoning. |
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