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KMID : 0876320000020010045
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Cachon Medical Journal
2000 Volume.2 No. 1 p.45 ~ p.52
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Prognostic Factor Analysis and Treatment Result of Patients with Acute Paraquat Poisoning
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Lim Young-Soo
Cho Hang-Seok
Park Hye-Yoon
Kim Kwon-Ki
Yang Seong-Hee
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Abstract
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Purpose: Our purposes are to evaluate therapeutic effect of Fuller´s earth as gastric lavage, superoxide dismutase as nebulizer and hemodialysis in acute paraquat poisoning and to analyze multiple variables affecting prognosis.
Methods: This study was carried out by retrospective follow-up from 1995 to March 1998. 48 paraquat-poisoned patients were hospitalized, 35 of them were enrolled. Statistic analysis were performed using Kaplan-Meier method as survival rate and survival curve, log-rank test as univariate analysis of prognostic factor and Cox regression as multivariate analysis.
Results: Among 48 subjects, 23 were male and 25 were female. Mean age was 48.5 ±17.5. Hemodialysis treatment group were 20 patients, non-hemodialytic treatment group were 15 patients. Gastric lavage treatment group were 26 patients and non-gastric lavage treatment group were 9 patients. Nebulizer treatment group were 20 patients and non-nebulizer treatment group were 15 patients. Combined treatments were done with each patient. The Survival time in below 50 year group was 351.95 ± 73.34 hr, in arterial blood 7.3 pH or above group was 340.69 ± 80.26 hr. That of 50 year or older group was 20.55±8.09 hr, in arterial blood below 7.3 pH was 121.41 ± 72.52 hr (p < 0.05). The survival time in urine paraquat concentration below 4 + group was 466.45 ± 101.23 hr, and urine paraquat concentration 4 + or above was 77.73 ± 61.35 hr (p < 0.05). The survival time of hemodialytic treatment group was 365.45±75.79 hr, and that of gastric lavage group through fullers earth was 285.38 ± 65.00 hr, of nebulizer group through superoxide dismutase was 342.40 ±76.64 hour. The survival time of all three treatment group was 398.12±83.10 hr. But, that of below three treatment group was 50.58±28.87 hr (p < 0.05 ).
Conslusion: The important factors affecting acute paraquat-poisoned patient are age, nebulizer treatment and arterial blood pH at emergency room.
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KEYWORD
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Hemodialysis, Paraquat poisoning, Superoxide dismutase, Prognostic factor
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