不同接触途径所致急性三氯丙烷中毒的临床分析

摘要

目的 研究不同途径所致急性三氯丙烷(TCp)中毒的临床特点.方法 将43例急性TCP中毒患者按接触途径分为口服组(15例)和吸入组(28例),分析其临床症状、肝功能指标及预后.结果 急性TCP中毒可累及呼吸系统、消化系统和神经系统.恶心、呕吐、腹痛、乏力症状较为常见,两组比较差异无显著性.胸闷在吸入组常见,头晕、意识不清在口服组较常见,两组比较差异有显著性.口服组谷丙转氨酶达峰值时间在中毒后(2.73±1.22)天,吸入组谷丙转氨酶达峰值时间在(7.05±3.82)天,两组比较差异有显著性.口服组的死亡率是吸入组的203.6倍.结论 不同接触途径所致急性TCP中毒临床表现具有一定差异；口服组患者的谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素峰值明显高于吸入组,且口服组谷丙转氨酶峰值出现时间早于吸入组；口服途径是急性TCP中毒患者预后的危险因素.%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, TB1L, DBIL were higher in oral group than in inhalation group. The oral exposure route was important risk factor of acute TCP patients.