臨床分析23例抗凝血滅鼠劑中毒導(dǎo)致的凝血障礙
本文選題:凝血酶原 + 維生素K; 參考:《重慶醫(yī)學(xué)》2016年15期
【摘要】:目的探討抗凝血類滅鼠劑中毒的臨床特點(diǎn)及治療方法。方法回顧性分析在該院診治的抗凝血類滅鼠劑中毒導(dǎo)致凝血功能障礙23例患者的臨床表現(xiàn)、實驗室檢查及維生素K1治療前后凝血功能變化。結(jié)果臨床以全身自發(fā)性出血為主要表現(xiàn)。凝血酶原時間(PT)、活化部分凝血酶原時間(APTT)和國際標(biāo)準(zhǔn)化比值(INR)均延長,凝血因子Ⅸ(FⅨ)活性顯著降低,凝血因子Ⅷ(FⅧ),凝血因子Ⅺ(FⅪ)和凝血因子Ⅻ(FⅫ)活性不變。用維生素K1治療后PT、APTT和INR與治療前比較明顯縮短(P0.01),凝血因子Ⅸ活性與治療前比較明顯升高(P0.01),凝血因子Ⅷ,Ⅺ,Ⅻ活性與治療前比較差異無統(tǒng)計學(xué)意義(P0.05);23例患者治療7d后凝血功能基本恢復(fù)正常。結(jié)論如患者有多部位反復(fù)出血表現(xiàn),且PT、APTT明顯延長,應(yīng)高度懷疑滅鼠劑中毒的可能。滅鼠劑中毒患者需接受維生素K1長療程治療。
[Abstract]:Objective to investigate the clinical characteristics and treatment of anticoagulant rodenticide poisoning. Methods the clinical manifestations of 23 patients with coagulation dysfunction caused by anticoagulant rodenticide poisoning were analyzed retrospectively. The changes of coagulation function before and after treatment with vitamin K1 and laboratory examination were analyzed retrospectively. Results the main clinical manifestation was systemic spontaneous hemorrhage. Prothrombin time (PT), activated partial prothrombin time (APTT) and international standardized ratio (INR) were prolonged, and the activity of coagulation factor IX (F IX) was significantly decreased. After treatment with vitamin K1, PTT APTT and INR were significantly shorter than those before treatment (P0.01), the activity of coagulation factor IX was significantly higher than that before treatment (P0.01). There was no significant difference in the activity of XII between before and after treatment (P0.05). The coagulation function of 23 patients returned to normal after 7 days of treatment. Conclusion if the patient has repeated bleeding and PTT APTT is prolonged, the possibility of rodenticide poisoning should be highly suspected. Patients with rodenticide poisoning need to be treated with vitamin K 1 for a long period of time.
【作者單位】: 廣西醫(yī)科大學(xué)第一附屬醫(yī)院檢驗科;
【分類號】:R595.4;R446.1
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