烟嘧磺隆中毒1例临床分析

Clinical Analysis of a Case of Nicosulfuron Poisoning

摘要: 烟嘧磺隆作为新型内吸性除草剂，对植物生长有氧化应激和抗坏血酸–谷胱甘肽(AA-GSH)循环作用，在动物体内达到一定浓度可致死，临床中毒案例少见，血白细胞计数、肌酐、ALT、AST、凝血酶原时间、D-二聚体、乳酸等指标与中毒严重程度呈正相关。相关研究表明血浆烟嘧磺隆药物浓度与致死率呈线性关系，根据以往农药中毒救治办法及相关报道，针对不同的中毒尽早脱离现场，选择催吐、洗胃、皮肤清洁等措施减少药物吸收，出现中毒症状者，尽早就医，对症治疗；对于重症患者，需早期严密监测，器官功能评估，重要脏器支持，血液净化以及血液灌流治疗可以快速、有效降低血液药物浓度，提高救治成功率。现就我们在临床中诊治的一例口服烟嘧磺隆患者进行了资料收集，现报告如下。

Abstract: Nicosulfuron methyl, as a new inhalant herbicide, has the effects of oxidative stress and ascorbic acid glutathione (AA-GSH) cycle on plant growth. It can be fatal when reaching a certain concentration in animals. Clinical poisoning cases are rare. Indicators such as blood leukocyte count, creatinine, ALT, AST, prothrombin time, D-dimer and lactic acid are positively correlated with the severity of poisoning. Relevant studies have shown that there is a linear relationship between plasma Nicosulfuron concentration and mortality. According to the previous treatment methods and relevant reports of pesticide poisoning, leave the scene as soon as possible for different poisoning, and take measures such as vomiting, gastric lavage and skin cleaning to reduce drug absorption. Those with poisoning symptoms should be treated as soon as possible; for severe patients, early close monitoring, organ function evaluation, important organ support, blood purification and hemoperfusion therapy can quickly and effectively reduce the blood drug concentration and improve the success rate of treatment. The data of a patient with oral Nicosulfuron in our clinical diagnosis and treatment are collected as follows.