儿童溴敌隆中毒以鼻出血为首发症状的病例 报道1例
A Case Report of Childhood Bromadiolone Poisoning Presenting with Epistaxis as the Initial Symptom
DOI: 10.12677/acm.2026.1662301, PDF,   
作者: 时 光：济宁医学院临床医学院，山东 济宁；王少华, 刘 涛, 张 宁, 祖小松, 李晓瑜*：济宁医学院附属医院耳鼻咽喉头颈外科，山东 济宁
关键词: 鼻出血；中毒；溴敌隆；长效抗凝血杀鼠剂；凝血功能障碍；Epistaxis； Poisoning； Brodifacoum； Long-Acting Anticoagulant Rodenticides； Coagulation Dysfunction
摘要: 溴敌隆属于第二代高效抗凝血杀鼠药，中毒后会引起皮肤黏膜及各脏器出血现象，部分中毒者，尤其儿童，可能因没有明确杀鼠药暴露史，前来就诊时易被误诊、延误治疗。本文回顾性分析一例儿童因间断鼻腔出血1周才来就诊的病例的临床资料及诊治过程，提示儿童不明原因鼻腔反复出血且凝血功能存在异常者，最好能排除溴敌隆中毒可能，以免延误病程。
Abstract: Bromadiolone is a second-generation high-efficiency anticoagulant rodenticide. Poisoning can induce bleeding from skin mucosa and various organs. For some poisoned individuals, especially children, the lack of a clear history of rodenticide exposure often leads to misdiagnosis and delayed treatment when they seek medical attention. This paper retrospectively analyzes the clinical data and diagnosis-treatment process of a pediatric case with intermittent nasal bleeding lasting one week before presentation. It is suggested that for children with unexplained recurrent nasal bleeding and abnormal coagulation function, bromadiolone poisoning should be ruled out to avoid delaying the disease progression.
文章引用：时光, 王少华, 刘涛, 张宁, 祖小松, 李晓瑜. 儿童溴敌隆中毒以鼻出血为首发症状的病例 报道1例[J]. 临床医学进展, 2026, 16(6): 973-978. https://doi.org/10.12677/acm.2026.1662301

参考文献

[1] Lin, G.D., Wu, J.Y., Peng, X.B., et al. (2022) Retrospective Analysis of Clinical Characteristics of and Treatment Strategies for Patients with Long‐Acting Anticoagulant Rodenticide Poisoning. Basic & Clinical Pharmacology & Toxicology, 131, 74-82. [Google Scholar] [CrossRef] [PubMed]
[2] Jia, Y., Zhan, Y., Huang, G., Deng, C. and Yu, H. (2024) Acute Long-Acting Anticoagulant Rodenticide Poisoning in Pregnancy: A Case Report. Frontiers in Pharmacology, 15, Article 1502596. [Google Scholar] [CrossRef] [PubMed]
[3] Nosal, D.G., van Breemen, R.B., Haffner, J.W., Rubinstein, I. and Feinstein, D.L. (2021) Brodifacoum Pharmacokinetics in Acute Human Poisoning: Implications for Estimating Duration of Vitamin K Therapy. Toxicology Communications, 5, 69-72. [Google Scholar] [CrossRef] [PubMed]
[4] Corke, P.J. (1997) Superwarfarin (Brodifacoum) Poisoning. Anaesthesia and Intensive Care, 25, 707-709. [Google Scholar] [CrossRef] [PubMed]
[5] Li, Q., Yu, W., Qu, Y., Wang, J., Mao, N. and Kang, H. (2021) Acute Toxic Encephalopathy Following Bromadiolone Intoxication: A Case Report. BMC Neurology, 21, Article No. 8. [Google Scholar] [CrossRef] [PubMed]
[6] Wang, H., Deng, L., Sun, B., Xing, C., Mao, H. and Wu, B. (2024) Bromadiolone May Cause Severe Acute Kidney Injury through Severe Disorder of Coagulation: A Case Report. BMC Nephrology, 25, Article No. 303. [Google Scholar] [CrossRef] [PubMed]
[7] 张泽亚, 梁伟文, 孙学春, 等. 溴敌隆投毒偶合颅脑损伤致出血性脑疝死亡1例[J]. 中国法医学杂志, 2023, 38(6): 720-721, 724.
[8] 王嫒, 李青峰, 安云芳, 等. 以鼻出血为主要表现的溴敌隆中毒临床诊治分析[J]. 中国眼耳鼻喉科杂志, 2026, 26(2): 134-137.
[9] Raharimanana, A., Cunat, S., Falaise, C., Oudot, C., Fournel, A. and Dargaud, Y. (2025) Hereditary Combined Deficiency of the Vitamin K-Dependent Coagulation Factors. Hämostaseologie, 45, 396-404. [Google Scholar] [CrossRef] [PubMed]
[10] Perrone, S., Raso, S. and Napolitano, M. (2025) Clinical, Laboratory, and Molecular Characteristics of Inherited Vitamin K-Dependent Coagulation Factors Deficiency. Seminars in Thrombosis and Hemostasis, 51, 170-179. [Google Scholar] [CrossRef] [PubMed]
[11] 胡璐璐, 闫智强, 尹兴红, 等. 以鼻出血为首发症状的溴鼠隆中毒1例[J]. 中国耳鼻咽喉头颈外科, 2024, 31(2): 133-134.
[12] 岳晓艳, 金爱春. 溴敌隆中毒伴脑出血1例报道[J]. 首都医科大学学报, 2020, 41(1): 137-139.
[13] Wu, Y., Chang, C., Chung, C., Lin, H., Wang, C. and Shen, M. (2009) Superwarfarin Intoxication: Hematuria Is a Major Clinical Manifestation. International Journal of Hematology, 90, 170-173. [Google Scholar] [CrossRef] [PubMed]
[14] 张哲英, 张明西, 赵星. 维生素K1长期治疗溴鼠灵中毒伴肝硬化1例[J]. 中国工业医学杂志, 2025, 38(1): 32-33.
[15] 任英, 马欣, 顾平. 一例溴敌隆中毒凝血功能障碍合并血栓的病例分析[J]. 中国处方药, 2023, 21(2): 72-74.
[16] Qian, W., He, C., Ren, Y., Xian, X., Jiang, Z. and Xu, S. (2023) Application of Nafamostat Mesylate for Anticoagulation in Hemoperfusion Therapy in Patients with Bromadiolone Poisoning: Case Reports. Heliyon, 9, e19811. [Google Scholar] [CrossRef] [PubMed]
[17] 赵万江, 龚进, 杨福成, 等. 168例抗凝血类灭鼠药中毒检测申请资料及其结果分析[J]. 职业卫生与应急救援, 2019, 37(4): 351-352.
[18] 陈小龙, 沈亚娟, 陈桂锋, 等. 儿童抗凝血灭鼠药中毒流行病学与防治探讨[J]. 中国小儿血液与肿瘤杂志, 2021, 26(3): 161-165.
[19] Burton, M.J. and Doree, C. (2004) Interventions for Recurrent Idiopathic Epistaxis (Nosebleeds) in Children. Cochrane Database of Systematic Reviews, No. 9, CD004461.
[20] Béquignon, E., Teissier, N., Gauthier, A., Brugel, L., De Kermadec, H., Coste, A., et al. (2017) Emergency Department Care of Childhood Epistaxis. Emergency Medicine Journal, 34, 543-548. [Google Scholar] [CrossRef] [PubMed]
[21] Yan, T. and Goldman, R.D. (2021) Recurrent Epistaxis in Children. Canadian Family Physician, 67, 427-429. [Google Scholar] [CrossRef] [PubMed]

为你推荐