Clinical Analysis Of Successful Treatment Of41Patients With Paraquat Poisoning

BackgroudParaquat (PQ) is one of the most extensively used herbicide in the world, causing thousands of deaths due to accidental or intentional self-poisoning every year. Paraquat poisoning has been a public health problem in both the developing and developed countries. Although many therapeutic treatments for PQ-induced poisonings have been proposed and developed, including pulse therapy with glucocorticoid, cyclophosphamide, continuous plasma perfusion, hemoperfusion with continuous venovenous hemofiltration, Lysine acetylsalicylate, vitamin C, traditional Chinese medicine, and so on, the efficacy of these treatments is still poor and requires further investigation.ObjectiveTo analyze clinical characteristics of41survival patients with paraquat poisoning and observe the development of their treatment and prognosis.MethodClinical data of41cases from Jan2011to Dec2011, should be recorded, including name, age, gender, marriage, work, address, telephone, admission time, poisoning time and dosage, clinical manifestation, examinations, etc. The examinations include plasma-paraquat and urine-paraquat concentrations, blood routine, D-Dimer, liver and kidney function, blood biochemical, myocardial enzymes and HRCT. The time points of observation are the day immediately after admission,7days,14days and21days after paraquat exposure,5weeks and13weeks after discharged.ResultsAmong the41cases, there were21male patients and20female patients. They were aged from16to63, whose average age was31. It was less than72hours from poisoning to rescue in all cases. Patients were followed up at5weeks and13weeks after discharged. All of the41cases survived. The ulcer of oral and lingual mucosa was observed in all of the41patients. The plasma-paraquat concentration was gradually lower following the time going on. The peak of urine-paraquat concentration was reached in7～14days. Through the therapeutic procedures, the examinations revealed the increases of WBC, NEU, D-Dimer, ALT, BUN, Cr, the decreases of potassium in serum. The HRCT can show clearly the changes of lung injury of paraquat poisoning, about ground glass opacity, fibrosis, mediastinal emphysema, pleural effusion and pleural thickening. It palys an important role in helping treatment and evaluating prognosis of paraquat poisoning.ConclusionThis study analyzed clinical characteristics of41survival patients with paraquat poisoning. They were treated with an appropriate and systematic therapeutics, by setting proper time points of observation and observing the results of examination. All of the41cases survived. So, the therapeutics are beneficial for treatment of paraquat poisoning. With guidance from this study, an evidence-based treatment may benefit patients with paraquat poisoning.