不同剂量维生素K1对急性溴敌隆中毒的疗效观察

Effects of different doses of vitamin K1 on acute bromadiolone poisoning

  • 摘要:
      目的  探讨不同剂量维生素K1对急性溴敌隆中毒凝血功能改善情况,并评估其疗效。
      方法  选取急诊医学科收治的32口服溴敌隆中毒患者为研究对象,根据维生素K1用量不同将其分为观察组(17例)与对照组(15例); 对照组静脉滴注维生素K1 20 mg/d, 同时进行洗胃、保肝、补液等常规治疗; 观察组静脉滴注维生素K1 40 mg/d, 常规治疗与对照组相同。记录治疗前后凝血功能指标和住院时间。
      结果  治疗后,所有患者临床症状均显著改善。2组治疗后凝血指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及国际标准化比值(INR)均较治疗前改善,差异有统计学意义(P < 0.05); 观察组凝血功能改善情况优于对照组,但差异无统计学意义(P>0.05)。中毒后至就诊时间 < 48 h患者的凝血功能指标水平优于中毒后至就诊时间≥48 h的患者,差异有统计学意义(P < 0.05)。观察组住院时间为(5.69±1.85) d, 短于对照组的(5.94±1.56) d, 但差异无统计学意义(P>0.05)。
      结论  维生素K1可有效改善溴敌隆中毒所致的凝血功能障碍,较大剂量的维生素K1可以促进患者凝血功能的恢复,加速临床症状的改善。

     

    Abstract:
      Objective  To investigate the effects of different doses of vitamin K1 in the improvement of coagulation function in patients with acute bromadiolone poisoning.
      Methods  A total of 32 patients with oral bromodiolone poisoning admitted to the department of emergency medicine were selected as study objects, and were divided into observation group(17 cases) and control group (15 cases) according to different dosage of vitamin K1. The control group was given intravenous infusion of vitamin K1 for 20 mg/d, conventional treatment such as gastric lavage, liver protection and fluid rehydration were performed, while the observation group conducted intravenous infusion of vitamin K1 for 40 mg/d, and routine treatment was the same as the control group. Coagulation function indexes before and after treatment and hospital stay were recorded.
      Results  After treatment, the clinical symptoms of all patients in the two groups were significantly improved. The coagulation indexes such as prothrombin time (PT), activated partial thrombin time (APTT) and international standardized ratio (INR) of the control group and the observation group were significantly improved after treatment compared with before treatment (P < 0.05), and the indexes of coagulation function in the observation group improved better than that of the control group, but there were no statistical significances between the two groups after treatment (P>0.05). The coagulation indexes of patients with time < 48 h from poisoning to treatment were better than those with time ≥48 h from poisoning to treatment, and the difference was statistically significant (P < 0.05). The length of hospitalization in the observation group was (5.69±1.85) d, which was shorter than (5.94±1.56) d in the control group, but the difference was not statistically significant (P>0.05).
      Conclusion  Vitamin K1 can effectively improve the coagulation dysfunction caused by bromadiolone poisoning. Higher dose of vitamin K1 can promote the recovery of coagulation function and accelerate the improvement of clinical symptoms.

     

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