急性百草枯中毒致肺损伤的发病机制及治疗(1)
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[摘要] 目的：探讨急性百草枯中毒致肺损伤的机制及其治疗方式。方法：选取我院50例百草枯中毒致肺损伤患者，给予胸片、CT等检查，给予清除毒物、血液净化、药物治疗等综合治疗。通过资料分析，总结发病机制及治疗方法。结果：肺间质病变、毛玻璃样变见于绝大多数患者，发生率均远远高于其他病变(P<0.05)。纵隔病变、心包病变等少见。治疗后，存活患者动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)均显著提高(P<0.05)；PaO2达90%以上，PaO2/FiO2达400以上，二氧化碳分压(PaCO2)显著减低(P<0.05)。50例患者中存活29例，死亡率为42%。结论：百草枯中毒致肺损伤机制较为复杂，综合疗法治疗百草枯中毒肺损伤效果确切，降低了死亡率。
[关键词] 百草枯；肺损伤；发病机制；治疗
[中图分类号] R979.8;R563 [文献标识码] B [文章编号] 1673-7210(2011)11(c)-171-02
Pathogenesis and therapies of lung injury caused by acute Paraquat poisoning
LONG Yong, ZENG Junfeng, JIANG Qian, RAO Shuping
Department of Emergency, the People's Hospital of Yichun City, Jiangxi Province, Yichun 336000, China
[Abstract] Objective: To investigate the pathogenesis and therapies of lung injury caused by acute Paraquat poisoning. Methods: 50 patients with acute Paraquat poisoning of our hospital were examined with chest radiograph and CT, and treated comprehensively including poison elimination, blood purification and pharmacotherapy. Then the pathogenesis and therapies were concluded through analyzing the data acquired. Results: The interstitial lung disease and ground-glass attenuation were discovered from most of the patients and the incidence was far higher than the other pathologic changes (P<0.05), while the mediastinal pathologic change and pericardial pathologic change occurred rarely. After the treatment, the arterial oxygen tension (PaO2), oxygenation index (PaO2/FiO2) of the survival patients were increased dramatically (P<0.05); PaO2 took over 90% and PaO2/FiO2 over 400, PaCO2 was decreased dramatically (P<0.05). The death rate out of 50 patients was 42%. Conclusion: The pathogenesis of lung injury caused by acute Paraquat poisoning is quite complicated. Adopting comprehensive therapy on this injury has a good curative effect with improving the patients’ respiratory function and decreasing the mortality.
[Key words] Paraquat; Lung injury; Pathogenesis; Treatment
急性百草枯 (Paraquat，PQ)为高效有机杂环类接触性脱叶剂和除草剂，但对人畜有极强的毒性，可造成以肺为主的多种脏器严重损伤，致死率极高[1] ......
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