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Retrospective analysis of 18 cases of occupational acute 1, 2-dichloroethane (1, 2-DCE) poisoning. The results showed that all patients have the main manifestations such as dizziness, headache, unresponsiveness and other symptoms of nervous system damage; Brain CT showed varying degrees of diffuse white matter lesions. Brain MRI showed extensive involvement of white matter in both cerebral hemispheres. Affected white matter area presented low intensity on T1WI, hyperintensity on T2WI and T2-Flair; Lumbar puncture examination of cerebrospinal fluid (CSF) pressure (262.5±48.39) mm H2O; After treatment, the required time for CSF pressure to restore was (161.56±75.27) days (50-280) days. Summary, Occupational acute 1, 2-DCE poisoning caused by toxic encephalopathy can be manifested as persistent abnormalities in CSF pressure, and the CSF pressure drops slowly during treatment; Early head CT and lumbar puncture examination will be helpful for early detection of intracranial pressure in toxic encephalopathy caused by acute 1, 2-DCE poisoning. Dynamic monitoring of CSF provides guidance for acute 1, 2-DCE poisoning with a long time of treatment and various types of dehydrating agents.
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OBJECTIVE: To analyze the clinical features, diagnosis and treatment of acute poisoning caused by colchicine. METHODS: The clinical data of 3 cases of acute colchicine poisoning were retrospectively analyzed. RESULTS: All the 3 cases had a clear history of colchicine overdose, at the doses of 30.0, 50.0 and 58.5 mg. These 3 cases had different degree of gastrointestinal symptoms, bone marrow restrain, rhabdomyolysis, myocardial damage and liver damage. After treatment, case 1 and case 2 were discharged. Case 3 had a long history of oral intake of colchicine. Severe metabolic acidosis and abnormal coagulation function occurred in the early stage, and the condition was dangerous. Despite active rescue treatments including blood purification, glucocorticoid, coagulation factors, liver pretection, heart protection and water electrolyte correction, death could not be prevented after taking colchicine 89 hours later.CONCLUSION: There is no specific antidote for colchicine poisoning. The prognosis is poor if there is severe metabolic acidosis and abnormal blood coagulation in early stage.
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Objective@#To analyze 8 cases of paraquat lung transplantation in the world, and to explore the timing of lung transplantation and the factors affecting prognosis.@*Methods@#An analysis of the clinical data of a paraquat poisoning lung transplant patient completed by The 12th People's Hospital of Guangzhou Medical University and The First People's Hospital affiliated to Guangzhou Medical University in August 2017 and literature review.@*Results@#A 26 years old female patient was admitted to the hospital ingested 20% paraquat solution 20ml. On the 58th day of poisoning, she underwent double lung transplantation under general anesthesia. The operation was successful. Excised lungs show extensive lung fibrosis in both lungs, which was consistent with paraquat poisoning. Used tacrolimus and corticosteroids and mycophenolate antirejection, the patient discharged 46 days after surgery. 7 articles were retrieved through the search tool, and a total of 8 articles included this case were reported. Five patients who underwent lung transplantation within 1 month after poisoning all died, And 3 patients conducted lung transplantation for more than 1 month after poisoning survived; Pathogenic bacteria were isolated from the sputum in 3 of the 8 cases, all containing Pseudomonas, 2 of which died, and our case survived.@*Conclusion@#Appropriate transplantation time window is very important for the prognosis of paraquat poisoning after lung transplantation. Active treatment of the sputum pathogens, improving the donor receptor matching, and exhausting the various means to remove the paraquat from the storage pool which may improve success rate of lung transplantation.
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Objective To explore the effect of contract learning on rehabilitation training to patients with stroke . Methods According to the random number table, 120 stroke patients were randomly divided in equal number into control group and observation group. The patients in the control group were treated with conventional nursing during hospitalization and health guidance during follow-up. The patients in the observation group were given rehabilitation training according to contracted learning during the period of hospitalization and follow-up. The time was 6 months. The quality of life was compared between the two groups of patients before and after the intervention, 1 months after discharge, 6 months after discharge. Results After six months of intervention, the 7 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, communication and participation in the intervention group were significantly better than those of the control group (P<0.001). The 6 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, and communication of the control group were significantly better than before the intervention (P<0.001). Conclusion For stroke patients, the rehabilitation training under the learning contract can improve the effect of rehabilitation training so as to improve the quality of life and the prognosis.
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al blood lactic acid monitoring is simple, easy and practical to use in predicting prognosis of ICU patients sensitively.