不同接觸途徑所致急性三氯丙烷中毒的臨床分析

摘要： 目的研究不同途徑所致急性三氯丙烷(TCP)中毒的臨床特點(diǎn)。方法將43例急性TCP中毒患者按接觸途徑分為口服組(15例)和吸入組(28例),分析其臨床癥狀、肝功能指標(biāo)及預(yù)后。結(jié)果急性TCP中毒可累及呼吸系統(tǒng)、消化系統(tǒng)和神經(jīng)系統(tǒng)。惡心、嘔吐、腹痛、乏力癥狀較為常見,兩組比較差異無顯著性。胸悶在吸入組常見,頭暈、意識不清在口服組較常見,兩組比較差異有顯著性?？诜M谷丙轉(zhuǎn)氨酶達(dá)峰值時間在中毒后(2.73±1.22)天,吸入組谷丙轉(zhuǎn)氨酶達(dá)峰值時間在(7.05±3.82)天,兩組比較差異有顯著性?？诜M的死亡率是吸入組的203.6倍。結(jié)論不同接觸途徑所致急性TCP中毒臨床表現(xiàn)具有一定差異;口服組患者的谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶、總膽紅素、直接膽紅素峰值明顯高于吸入組,且口服組谷丙轉(zhuǎn)氨酶峰值出現(xiàn)時間早于吸入組;口服途徑是急性TCP中毒患者預(yù)后的危險因素。
Objective To study the clinical characteristics of acute trichloropropane(TCP) poisoning by different exposure routes.Methods The forty-three cases of acute TCP poisoning were divided into two groups according to their exposure routes,namely oral group and inhalation group,to analysis their clinical features,liver function tests and prognosis.Results Respiratory system,digestive system and nervous system were involved.Nausea,vomiting,abdominal pain and fatigue were the common toxic manifestations of acute TCP poisoning patients.The differences were not significant.Chest tightness was common in inhalation group,dizziness and unconsciousness was common in oral group.The differences were statistically significant.The time that the value of ALT reached the peak was 2.73±1.22 day and 7.05±3.82 day in oral group and inhalation group,respectively.The difference was statistically significant.The mortality of oral group was 203.6 times that of inhalation group.Conclusion The distribution of symptoms caused by different exposure routes made some slight difference in acute TCP poisoning paitents.The values of ALT,AST,TBIL,DBIL were higher in oral group than in inhalation group.The oral exposure route was important risk factor of acute TCP patients.