Effect Of Lung And Kidney Injury Sequence On Prognosis In Patients With Paraquat Poisoning

Objective:In this study,we collected the clinical data of paraquat poisoning patients,and discussed the effect of lung and kidney injury sequence on prognosis.Method:The clinical data of 175 patients diagnosed with paraquat poisoning were retrospectively analyzed.According to the order of lung and kidney injury,the patients were divided into 3 groups.Renal injury was prior to lung injury group(group A),lung injury was prior to kidney injury group(group B),and lung and kidney damage group(group C).The time of taking poison to gastric lavage,the time from taking poison to admission,age,sex,the time from taking poison to lung damage,and taking poison to kidney damage admission APACHE Ⅱ score,PSS score,were compared.Results:1.There was no statistically significant difference between the three groups in terms of the time from taking poison to gastric lavage,the time from taking poison to admission,and gender(p>0.05).There were statistically significant differences in the dose,age,the time from taking poison to lung damage,and the time from taking poison to kidney damage(p<0.01).However,there was no correlation between age and the time to kidney damage on prognosis(p>0.05),while there was a correlation between the time to lung damage and dose on prognosis(p<0.001).2.The prognosis of group A was significantly better than that of group B,with statistically significant difference(X~2=8.32,P<0.01);the prognosis of group A was significantly better than that of group C,with statistically significant difference(X~2=55.95,P<0.001);the prognosis of group B was significantly better than that of group C,with statistically significant difference(X~2=21.04,P<0.001).3.There were statistically significant differences in admission APACHEⅡ score and PSS score among the three groups(p<0.01),and there was a correlation between admission APACHE Ⅱ score and prognosis(p<0.01),while there was no correlation between PSS score and prognosis(p>0.05).4.The dose,the time to lung damage,and APACHE Ⅱ score had an evaluation value for the prognosis(p<0.001).The higher the dose,the shorter the time to lung damage,and the higher the APACHE Ⅱ score,the worse the prognosis.Conclusion:1.The order of lung and kidney injury sequence has an impact on the prognosis:(1)The lung and kidney injury group had the worst prognosis;(2)The renal injury prior to the lung injury group had a better prognosis than the lung injury group before the kidney injury group.2.The dose of poison,the time from poison to lung damage,and APACHE Ⅱ score also have good prognostic value.