临床分析23例抗凝血灭鼠剂中毒导致的凝血障碍

发布时间：2018-07-04 19:27

本文选题：凝血酶原 + 维生素K　；参考：《重庆医学》2016年15期

【摘要】：目的探讨抗凝血类灭鼠剂中毒的临床特点及治疗方法。方法回顾性分析在该院诊治的抗凝血类灭鼠剂中毒导致凝血功能障碍23例患者的临床表现、实验室检查及维生素K1治疗前后凝血功能变化。结果临床以全身自发性出血为主要表现。凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)和国际标准化比值(INR)均延长,凝血因子Ⅸ(FⅨ)活性显著降低,凝血因子Ⅷ(FⅧ),凝血因子Ⅺ(FⅪ)和凝血因子Ⅻ(FⅫ)活性不变。用维生素K1治疗后PT、APTT和INR与治疗前比较明显缩短(P0.01),凝血因子Ⅸ活性与治疗前比较明显升高(P0.01),凝血因子Ⅷ,Ⅺ,Ⅻ活性与治疗前比较差异无统计学意义(P0.05);23例患者治疗7d后凝血功能基本恢复正常。结论如患者有多部位反复出血表现,且PT、APTT明显延长,应高度怀疑灭鼠剂中毒的可能。灭鼠剂中毒患者需接受维生素K1长疗程治疗。
[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.
【作者单位】：广西医科大学第一附属医院检验科;
【分类号】：R595.4;R446.1

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