The Prognostic Analysis Of The Patients With Acute Paraquat Intoxication

Paraquat has a small amout to make people die,and has no special effectsmedicine.It has toxicity to all the organs and tissue,so paraquat intoxication isthe most difficult problem of clinical workers.The patients with large doses ofparaquat die in a short time because of MOF,however the patients who pass theacute phase may happen irreversible pulmonary fibrosis,and later die ofrespiratory failure or MOF.Objective In this study,we retrospectively analyze the patients who werein our hospital emergency room with paraquat poisoning,to investigate theprognostic factors of paraquat poisoning and reasonable treatment.Methods All60patients with acute paraquat intoxication were admittedfrom First Hospital of Jinlin University with clarified diagnosis and completeinformation from January,2010to September,2011. All patients were dividedinto two groups: survival group(31cases) and deceased group(29cases). Thestudy analyze the clinical information, laboratory data and situation of organfailure between two groups.Results (1) Compere with survival group,the patients in deceased guouphave taken much paraquat and had high grade of oral ulcer. The differencebetween the two groups is obvious,and has statistical significance(P<0.01). Butthere are no difference between two groups in age, sex, admission time(gastriclavage time), hemoperfusion time and the number of perfusion.(2)The level ofnumeration of leukocyte and neutrophils percentage,the function of liver andkidney,creatine kinase,PCO2and Lac in deceased group are higher thansurvival guoup,and have significant differences (P<0.05). HCO-3in deceasedgroup is lower than in survival.(3)The patients in two groups have differentdegree of organ failure.In survival group,the organ failure rate in descending order is ARF,toxic hepatitis,toxic pancreatitis,toxic myocarditis,gastrointestinalbleeding and ARDS.The order in deceased group is ARF,ARDS,toxichepatitis,toxic myocarditis,toxic pancreatitis and gastrointestinal bleeding.Compered with the two groups,ARDS、ARF、toxic hepatitis and gastrointestinalbleeding have statistical significance.(4) ROC curve prompt amout taken hasthe biggest AUC,and next is HCO3-,Lac, numeration of leukocyte,glutamic-pyruvic transaminase and creatinine.Conclusions (1)The patients who take large dose of PQ and have highgrade of oral ulcer will have a bad prognosis.(2) Laboratory parameters canearly prompt the prognosis of paraquat poisoning patients.It includesnumeration of leukocyte and neutrophils percentage,transaminase,urea nitrogenand creatinine,creatine kinase,PCO2,HCO-3and Lac.(3) Acute pataquatpoisoning patients has a high organ failure rate,and it is related withprognosis.Lung injury is almost irreversible.The patients with ARDS have abad prognosis.Among all the organs failure,ARF is highest,but it is not deadlycomplications.(4) More factors can influence the prognosis of paraquatpoisoning patients.The ability of prognosis discrimination successively isamount taken, HCO-3,Lac, numeration of leukocyte, glutamic-pyruvictransaminase and creatinine.