Exploration Of The Clinical Characterstics,Prognosis And Control Strategy For Methyl Bromide Poisoning

Objective:By analysis of the clinical data on the diagnosis and treatment in patients with methyl bromide poisoning,and the relevant literature on this issue,we aimed to explore the clinical features,therapeutic strategies and prognosis of methyl bromide poisoning.This study could provide evidence-based evidence for clinicians and patients to choose the appropriate treatment options.At the same time,based on this survey of methyl bromide uses,we want to detect the control strategy and reduce the incidence of methyl bromide poisoning.Methods:The study analyzed the etiology,clinical symptom,treatment and prognosis of 12 patients with methyl bromide poisoning admitted to Qilu Hospital of Shandong University from April 2012 to December 2017 retrospectively.In the total 12 subjects,10 were male and 2 were female.They were 23-66 years old,with median age of 39.5 years old.The farmers accounted for the mail part.Then we made a reasonable search strategy and retrieved the English and Chinese database,including PubMed,Cochrane Library,National Guideline Clearinghouse,China Guideline Clearinghouse,Chinese academic Literature General Library(CNKI),Wanfang data base and Chinese databases of Biomedical literature database(CBM),etc.Through integrative analysis based on our data and the relevant studies,we found the appropriate treatment strategy to reduce mortality and complications of patients with methyl bromide poisoning,achieving the best outcome.Results:(1)Among all patients,acute poisoning rate was 83.33%,occupying first place.The first clinical manifestations were mainly the dizziness and fatigue(41.67%).The neuropathic syndrome was predominant,coma accounting for 41.67%(n=5).(2)The laboratory results showed that the increase of leucocyte was most common,with the percentage of 75%.(3)Imaging technique:among 8 patients underwent chest CT examination,5 patients were observed abnormal.When 12 patients took the cranial MRI,2 patients were abnormal.(4)Electrophysiological detection:there were 8 patients undergoing EEG dectection,with 6 patients detected abnormal.Three patients had electromyogram examination with abnormal results.(5)Among 12 cases,10 cases were cured and discharged from hospital,including 4 cases without sequela,6 cases left varying degrees of neurological deficit.Other 2 died after rescue.Conclusions:1.The prognosis of patients with methyl bromide poisoning is associated with the patient's age,exposure time to poison,degree of intoxication and subsequent treatment and rehabilitation.Although the current therapies have some therapeutic effects,the overall outcomes are not yet satisfactory.The recovery after the poisoning is slow,with high disability and poor prognosis.Thus,the clinical features,therapeutic strategies and prognosis of methyl bromide poisoning still need to be clarified.2.In order to reduce the incidence of methyl bromide poisoning,our study explore some control strategies.First of all,the relevant state medical departments should fulfill their responsibility,and give strong support to the research and development of novel agents and techniques representing methyl bromide.Secondly,the manufactures should abide by the law and enhance production safety.Lastly,the operators must reinforce the individual protection to safeguard their health and security of life.