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目的探讨急性苯的氨基、硝基化合物中毒的临床特点。方法收集1995—2012年收治的102例职业性苯的氨基、硝基化合物中毒患者的临床资料,对其临床特点进行回顾性分析。结果 102例患者中男性93例,女性9例;年龄中位数(M)为38(17~61)岁;接触反应5例,轻、中、重度中毒分别为69、21、7例;潜伏期M为2 h(10 min~14 h)。99例患者(占97.06%)出现紫绀,21例患者(占20.59%)合并溶血性贫血,高铁血红蛋白(MHb)水平与临床诊断分级符合率为58.62%。17例患者(占16.67%)出现膀胱刺激症状。102例患者经积极治疗后101例痊愈,1例因多脏器功能衰竭而死亡,治愈率为99.02%;住院时间M为7(1~55)d。结论急性苯的氨基、硝基化合物中毒临床以血液系统损害为主要表现,可伴有肝脏、肾脏损害,严重者可导致死亡,实验室测得MHb水平与病情并不完全相符,应用特效药亚甲蓝治疗效果好。
Objective To investigate the clinical characteristics of acute benzene amidosis and nitro compound poisoning. Methods The clinical data of 102 patients with occupational benzene and nitrochloride poisoning from 1995 to 2012 were collected and their clinical features were retrospectively analyzed. Results Among the 102 patients, 93 were males and 9 were females. The median age (M) was 38 (17-61) years old. There were 5 contact reactions in the 102 patients, with 69, 21, and 7 mild, moderate and severe toxicities respectively. M is 2 h (10 min ~ 14 h). Cyanosis was found in 99 patients (97.06%), hemolytic anemia in 21 patients (20.59%), and methemoglobin (MHb) level was 58.62% in accordance with clinical diagnosis. Seventeen patients (16.67%) experienced bladder irritation. One hundred and two patients were cured after active treatment and one died of multiple organ failure. The cure rate was 99.02%. The length of stay in hospital was 7 (1-5 days). Conclusion The clinical manifestations of acute benzene amidosis and nitro compound poisoning are as follows: blood system damage is the main manifestation, but liver and kidney damage may occur. In severe cases, MHb level may not be completely matched with the condition. A blue treatment is good.