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The value of toxicological analysis in acute poisoning patients with uncertain exposure histories:a retrospective and descriptive study from an institute of poisoning

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World Journal of Emergency Medicine 2024年第2期15卷 98-104页

作者： Qifang Shi gen ba.zhenyu xia.zhengsheng ma. Hao Sun Jinsong Zhang Institute of Poisoning Nanjing Medical UniversityNanjing 211100China Department of Emergency Medicine the First Affiliated Hospital of Nanjing Medical UniversityNanjing 210029China Department of Forensic Medicine Nanjing Medical UniversityNanjing 211166China The Key Laboratory of Modern Toxicology of Ministry of Education Nanjing Medical UniversityNanjing 211166China

baCKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison *** aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis ***:This was a retrospective and descriptive study from an institute of *** registration informa.ion and test reports spanning the period from April 1,2020 to ma.ch 31,2022,were *** with uncertain exposure histories and who underwent toxicological analysis were *** ma.ifestations and categories of toxics were ***:Among the 195 patients with positive toxicological analysis results,the ma.n causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical ma.ifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnorma.ities(8.7%).A comparison of clinical ma.ifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The ma.n categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical ma.ifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

关键词： Acute poisoning Toxic exposure Toxicological analysis Clinical ma.ifestation

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