Clinical Analysis Of Inpatients With Acute Aconitum Alkaloid Poisoning

Objective :To analyze the clinical characteristics of inpatients with aconitine poisoning in Yuxi People’s Hospital,and find out the indicators related to poor prognosis,so as to provide scientific basis for the diagnosis and treatment of patients with severe aconitine poisoning,so as to reduce the mortality of this disease.Methods: Clinical data of 160 patients with acute aconitine poisoning admitted to our hospital from January 2016 to January 2022 were retrospectively analyzed,including: Gender,age,underlying disease,length of hospital stay,type of poison,incubation period,clinical manifestations,vital signs,laboratory indicators on the day of diagnosis of acute aconitine poisoning,electrocardiogram findings,whether or not blood purification therapy and blood purification therapy,duration of vasoactive drug use,mechanical ventilation time,discharge status,PSS score,APACHE Ⅱ score,Curtis-walker ECG arrhythmia score,according to the outcome of the patients were divided into survival group and death group.The clinical features of the two groups were analyzed and the risk factors of death in patients with acute aconitine poisoning were discussed.Results: A total of 160 patient were included in the final analysis,with 151 people living in the group and nine in the dead group,and the death rate was 5.63%.In the case of 51.25 percent of patients with ucea,40.0% of the patients were poisoned by eating a stews,the rest of them are taken from Chinese medicine,which is containing grass,Chinese medicine and foreign use of an acid alcohol,which accounted for8.75 percent.The neurological system,cardiovascular system,and digestive symptoms were the most common clinical manifestations,and they were most common in oral tongue and body numbness,arrhythmia and nausea and vomiting.97.5 percent of the patients combined with the symptoms,47.5 percent of the patients with shock,33.75% of the patients with different levels of cognitive impairment,71.25% of patients combined with two above arrhythmia.The death group was more aged than the survival group and the average artery was depressed in the survival group,with statistical differences(P<0.05).The death group APACHE II scores the PSS score and the ecg curtis-walker rate was higher than the survival group,and there was a statistical difference(P<0.05).The death group Glasgow coma score was lower than the survival group,with statistical differences(P < 0.05);The death group had a statistical difference in the time of mechanical ventilation and the use of the pill time.In the laboratory data,the group and the survival group were above the survival group,the nt-probnp was higher than the survival group,and the serum total calcium death group was lower than the survival group,and there was a statistical difference(0.05),and the APACHE II score was the maximum value of the death prediction for acute urcephine poisoning(0.941).APACHE II score and NT-pro BNP were independent influencing factors for death in patients with acute aconitine poisoning in this study(both P<0.05).Conclusions: 1.In this study,the main causes of aconitine poisoning in inpatients with aconitine poisoning are eating stew aconitine,decocting tablets and taking aconitine containing medicine wine in our hospital.The risk of death after acute aconitine poisoning in the elderly is high,so health education and poisoning prevention of key groups should be further strengthened.2.Numbness,arrhythmia,nausea and vomiting were the most common symptoms of acute aconitine poisoning.71.25% of patients have two or more arrhythmias.APACHE II score is the most effective in predicting the risk of death in patients with acute aconitine poisoning Followed by NT-pro BNP,duration of pressor drug use,PSS score,mechanical ventilation duration and troponin T(area under ROC curve > 0.8).Therefore,for acute aconitum alkaloid poisoning,patients with high APACHE II score and PSS score,especially those with severe arrhythmia,circulatory failure and respiratory failure,have a high risk of death,which requires clinicians to focus on and actively intervene early to reduce the mortality of this disease.3.APACHE II score and NT-pro BNP are independent influencing factors for death in patients with acute aconitine poisoning in this study(both P<0.05).