Résumé
Objective@#To explore the risk factors influencing the prognosis of elderly patients with acute poisoning.@*Methods@#We retrospected 177 elderly patients with Acute Poisoning who were treated in the emergency department of the first affiliated hospital of wenzhou medical university from July 2009 to May 2015. According to the outcome of patients, we distributed the patients to death group (31 cases) and survival group (146 cases) , compared the clinic data and using multivariate analysis with Logistic regression to prognosis factors.@*Results@#There were 177 cases in total, with 146 survivors (82.5%) and 31 deaths (17.5%) . In which 102 cases (57.6%) had chronic underlying diseases. There were 28 cases of pesticide poisoning in the death group, and the fatality rate of pesticide poisoning was 23.5%. The mortality rate was 12.8% in the 60-69 years-old group (11/86) , 20% (13/65) in the 70-79 years-old group, 26.9% (7/26) in the 80-89 years-old group. The most common reason of poisoning was intentional ingestion, with 100 cases (56.5%) . The tract of the poisoning was mainly in digestive system, including 148 cases (83.6%) . The PSS score and APACHE-II score were 2.97±0.18 and 19.8±2.8 in the death group, 2.27±0.81 and 12.8±5.3 in the survival group. Compared with the survival group, poison (pesticides or non) 、poisoning route、cause of poisoning、PSS score、APACHEⅡ score have significant difference in death group (P<0.05) . Poison (pesticides or non) 、PSS score、APACHEⅡ, were the independent risk factors of poor prognosis.@*Conclusion@#Most of the elderly patients with acute poisoning have one or more chronic underlying diseases, the digestive tract ingestion and pesticide poisoning are more common. The fatality rate of the old patients is significantly higher than that of non elderly poisoning. Type of toxications, PSS score and APACHE-II score are the prognostic factors in elderly patients.
Résumé
Objective To investigate the effects of serum isoenzyme and inflammatory factors by large doses of methyl prednisolone shocktherapy in the treatment of patients with acute hundred withered grass poisoned.Methods 46 cases of patients with acute hundred withered grass poisoned from June 2014 to October 2015 in ningbo medical center lihuili hospital were collected and randomly divided into two groups,23 cases in each group.On the base of the conventional treatment,patients in the control group were treated by blood perfusion therapy,patients in the experiment group were treated with large dose of methyl prednisolone shock therapy on the base of the control group,tested and compared the levels of serum enzyme and inflammatory factors before and after treatment,observed the clinical symptoms,clinical efficacy and adverse reactions.Results Compared with before treatment,the levels of IL-1,IL-10,TNF-αand CRP in two groups were decreased (P<0.05),levels of CK, CK-MB, TGF-β1 and HIF-1αdecreased (P<0.05);Compared with the control group,the levels of IL-1,IL-10, TNF-αand CRP in the experiment group were lower (P<0.05);CK,CK-MB,TGF-β1 and HIF-1αlevels were lower (P<0.05),after treatment from the last row of green time,the plasma PQ clearance time and length of hospital stay were shorter (P<0.05),total effective rate was higher (P<0.05).Conclusion Large doses of methyl prednisolone shock therapy in the treatment of patients with acute hundred withered grass poisone has definite clinical efficacy , can reduce the patients’serum CK,CK-MB,TGF-β1,HIF-1αand inflammatory factors levels, with higher security.