METANOL ZEHİRLENMESİ NEDENİYLE ACİL SERVİSE BAŞVURAN HASTALARIN RETROSPEKTİF ANALİZİ

Öz

Amaç: Metanol zehirlenmesi ülkemizde son zamanlarda sıkça karşılaşılan bir zehirlenme türüdür. Zehirlenme durumunda vakaların hızla tanınıp tedavi altına alınması sayesinde mortalite ve morbidite oranları azaltılabilir. Bu çalışmanın amacı, acil servise başvuran metanol zehirlenmesi hastalarının demografik özellikleri, fizik muayene bulguları ve laboratuvar sonuçları ile sağ kalım arasındaki ilişkiyi araştırmaktır.

Gereç ve Yöntemler: Hastalar metanol zehirlenmesi sonrası eksitus olanlar ve hayatta kalanlar olmak üzere 2 farklı gruba ayrıldı. Tüm hastaların demografik özellikleri, başvuru şikayetleri, fizik muayene bulguları ve laboratuvar sonuçları ve klinik sonlanımları kaydedildi. Grupların karşılaştırılmasında Chi-square, Student t-test ve Mann-Whitney U testi kullanıldı. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi.

Bulgular: Çalışmaya metanol zehirlenmesi sonrası eksitus olan (n=5) ve hayatta kalanlar (n=12) olmak üzere toplam 17 hasta dahil edildi. Metanol zehirlenmesi sonrası en sık başvuru şikâyeti görme bozukluğu (%70.6) iken, bunu nefes darlığı (%35.3) ve bulantı-kusma (%35.3) takip ediyordu. Gruplar arasında başvuru şikâyeti bakımından farklılık saptanmadı. Her iki grupta da başta solunum sayısı (hiperventilasyon) olmak üzere vital bulguların ortalama değeri, normal değerinin üstündeydi. Ancak, vital bulgular bakımından gruplar arasında farklılık saptanmadı. Eksitus olan hasta grubundaki kreatinin düzeyi ve baz açığı seviyesi hayatta kalan gruptakilere göre anlamlı olarak artmışken, bikarbonat ve pH düzeyi ise anlamlı oranda azalmış olarak tespit edildi (sırasıyla p=0.015; 0.002, 0.020; 0.002).

Sonuç: Metanol zehirlenmesi sonrası ölen hastalarda, kreatinin değerindeki ve baz defisitindeki artış, derinleşen asidoz ve azalmış bikarbonat düzeyi kötü klinik sonlanımla uyumludur. Görme bozukluğuna eşlik eden hiperventilasyon ve bilinç kaybı durumlarında metanol zehirlenmesi akla gelmeli ve bir an önce uygun tedavi prosedürlerine başlanmalıdır.

Anahtar Kelimeler

• Formik asit
• Asit-Baz dengesi
• Sağ kalım
• Asidoz
• Metanol

Retrospectıie Analysis of Patients Admıited to the Emergency Department Due to Methanol Poisoning

Öz

Objective: Methanol poisoning has become a frequently encountered type of poisoning in our country recently. In case of poisoning, mortality and morbidity rates can be reduced by rapidly recognizing and treating the cases. The aim of this study is to investigate the relationship between survival and the demographic characteristics, physical examination findings and laboratory results of methanol poisoning patients admitted to the emergency department.

Material and Methods: Patients were divided into 2 different groups as exitus after methanol poisoning and survivors after methanol poisoning. Demographic characteristics, presentation complaints, physical examination findings and laboratory results and clinical outcomes of all patients were recorded. Chi-square, Student t-test and Mann-Whitney U tests were used to compare the groups. A value of p<0.05 was considered statistically significant.

Results: A total of 17 patients, including exitus after methanol poisoning (n=5) and survivors (n=12), were included in the study. The most common complaint after methanol poisoning was visual impairment (70.6%), followed by shortness of breath (35.3%) and nausea-vomiting (35.3%). There was no difference between the groups in terms of admission complaints. The mean value of vital signs, especially respiratory rate (hyperventilation), was above the normal value in both groups. However, there was no difference between the groups in terms of vital signs. While creatinine level and base deficit level in the deceased patient group were significantly increased compared to those in the survivor group, bicarbonate and pH levels were found to be significantly decreased (p=0.015; 0.002, 0.020; 0.002, respectively).

Conclusion: In patients who died after methanol poisoning, increase in creatinine value and base deficiency, deepening acidosis and decreased bicarbonate level are consistent with poor clinical outcome. In cases of hyperventilation and loss of consciousness accompanying visual impairment, methanol poisoning should be considered and appropriate treatment procedures should be initiated as soon as possible.

Anahtar Kelimeler

• Formic acid
• Acid-Base balance
• Survival
• Acidosis
• Methanol

Kaynakça

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