농약중독 환자에서 초기에 실시된 혈액학적 검사가 예후에 미치는 영향

Abstract

Background : To determine the prognostic values of the hematologic parameters checked initially in pesticide poisoning patients, we evaluated and compared the relationship between hematologic parameters and clinical pathologic factors of pesticide poisoning patients. Method : The initial hematologic parameters were measured from stored plasma samples, EDTA preserved samples, citrated blood samples and urine samples. Patients were grouped according to result of treatment. The severely intoxicated group consisted of expired patients, hopeless discharged patients and those admitted into the intensive care unit for over 7 days. The mildly intoxicated group had none of the indications seen in the severely intoxicated group. Paraquat intoxicated patients, patients with chronic diseases and patients with terminal malignancies were excluded from our study. The measured laboratory tests were done during ER visits. The statistical significance of the initial hematologic parameters was compared between the two groups. Results: During the study period, 437 patients visited the ER for pesticide poisoning. 392 patients had indication of mild intoxication, but 45 patients had indications of severe intoxication. Complete blood , white blood cell and platelet counts all showed statistically significantly differences (p<0.05), as did. ammonia level(p<0.05). ALT, AST, creatinine and amylase level were significantly different in initial chemistry testing, as well (p<0.05). In other tests, PT and aPTT had a statistically significant difference, but INR, coagulation activity and urinary analysis showed no significant changes in our study. Conclusion : Until now, the prognostic factors of pesticide poisoning patients have been based on the clinical presentation. In our study, several initial laboratory tests performed on pesticide poisoning patients had a statistical significance in the patients' prognosis. Therefore, initial hematologic parameters were useful in making decisions regarding the prognosis of pesticide poisoning patients.