临床误诊误治2017，Vol.30Issue(6)：33-35,3.DOI:10.3969/j.issn.1002-3429.2017.06.013
抗凝血杀鼠剂中毒27例误诊误治剖析
Analysis of Misdiagnosis and Mistreatment in 27 Patients with Anticoagulant Rodenticide Poisoning
摘要
Abstract
Objective To analyze clinical characteristics and misdiagnosis causes of anticoagulant rodenticide poisoning in order to improve final diagnosis rate.Methods Clinical data of 27 misdiagnosed patients with anticoagulant rodenticide poisoning admitted during December 2013 and September 2016 was retrospectively analyzed.Results The misdiagnosed time was 1 day-7 months, and the average time was 24.8 days.Clinical manifestations were 23 patients with hematuria, 10 patients with gingival (oral) bleeding, 8 patients with otorrhagia or nasal bleeding, 5 patients with limb pain or activity limitation, 4 patients with vaginal bleeding or menorrhagia, 2 patients with back pain, 2 patients with abdominal pain and 1 patient with hematochezia and 1 patient with disorders of hemostasis.The misdiagnosed time was 43 times including 14 diseases, and the top four misdiagnosed diseases were as follow ureteral calculi, coagulation disorders, urinary infection and gingival bleeding.There were 21 patients with different degrees of anemia and 19 patients with coagulation disorders.There were 18 patients with brodifacoum, 18 patients with bromadiolone and 9 patients with brodifacoum and bromadiolone by blood detection.After confirming the diagnosis, the patients received treatments such as fluid replacement and decorporation, vitamin K1 supplement, plasma infusion and hemoperfusion with good prognoses.Conclusion Anticoagulant rodenticide poisoning is insidious with various clinical manifestations, and therefore clinicians should give related examinations in time in order to avoid misdiagnosis and mistreatment for highly suspected patients with anticoagulant rodenticide poisoning.关键词
中毒/误诊/尿路结石/泌尿道感染Key words
Poisoning/Misdiagnosis/Urinary calculi/Urinary tract infections分类
医药卫生引用本文复制引用
董建光,邱泽武,张鹏,鲁晓霞,龙剑海,彭晓波,王春燕,刘燕青,白丽丽,王浩春..抗凝血杀鼠剂中毒27例误诊误治剖析[J].临床误诊误治,2017,30(6):33-35,3.基金项目
国家卫生与计划生育委员会公益性行业科研专项课题(201502043) （201502043）
