| Objective: To summarize the clinical manifestations,diagnosis,treatment,and prognosis of children's acute paraquat poisoning;to understand the correlation factors of intoxication prognosis;and to guide the future treatment of paraquat poisoning.Methods: The study included 28 children from July 2011 to September 2018 who were definitely subjected to acute paraquat poisoning.According to the prognosis which were divided into two groups)survival group and death group),by retrospective analysis of the clinical manifestations,auxiliary examinations,and treatment modalities between two groups and following up the survival of these children,explore the risk factors that influence prognosis.Rsults: Twenty-eight children with paraquat poisoning survived 25 cases,3 died,and the mortality rate was 10.71%.The general condition of the follow-up survival group was 25 cases.At the time of admission,there were statistically significant differences between the survival group and the death group in plasma paraquat concentration,severity index of paraquat poisonin,white blood cell count,creatine kinase,creatine kinase isoenzyme,alanine aminotransferase,aspartate aminotransferase,serum potassium concentration,blood urea,blood creatinine,blood uric acid and blood amylase(P<0.05).Logistic regression analysis showed that creatine kinase isoenzyme,serum potassium concentration,serum creatinine and severity index of paraquat poisonin were independent risk factors for early prognosis of paraquat poisoning(P<0.05).There was no significant difference in the treatment of vomiting,gastric lavage,blood purification,glucocorticoids and immunosuppressive agents between the two groups(P>0.05).Conclusion:1.28 children with paraquat poisoning died in 3 cases,the mortality rate was 10.71%,which was lower than the domestic reports,and 25 cases of surviving group were complained of quality of life.It can be seen that the paraquat treatment plan summarized by our hospital is much effective.2.The results showed that the severity index of paraquat poisoning(plasma paraquat concentration * time from poisoning to visit),creatine kinase isoenzyme,serum potassium concentration and serum creatinine were used as monitoring indicators of paraquat poisoning prognosis.3.Organ damage such as lung,heart,liver,kidney,pancreas,and nervous system may be closely related to the prognosis of acute paraquat poisoning.4.Blood purification,especially hemoperfusion,has special value in the treatment of paraquat poisoning children. |
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