Abstract Objective To summarize the clinical characteristics and therapeutic effect of second-generation anticoagulant rodenticide poisoning, so as to improve the understanding and diagnosis and treatment of this disease. Methods We retrospectively analyzed 71 misdiagnosed cases with anticoagulant rodenticide poisoning, admitted to Poisoning Treatment Center of the Army during December 2013 and September 2016, including the general situation, the cause of poisoning, poisoning time, clinical manifestation, hemoglobin and blood coagulation function, poison detection, diagnosis, prognosis and so on. Results 71 patients with anticoagulant rodenticide poisoning comprised 44 males and 27 females with an average age of 40 years (15 to 79). The average poisoning time was 12 days, and the average hospitalization time was 12 days. 10 patients were mild poisoning, 24 patients were moderate poisoning, and 37 patients were severe poisoning. The index of blood coagulation function was significantly better than that of admission, which was statistically significant. The average amount of vitamin K1 intake was 60 mg/d, the dosage was 10 mg/d after discharge, the average vitamin K1 time of withdrawal was 3 months after discharge, and the average concentration of anticoagulant rodenticide was 11 ng/mL when vitamin K1 was stopped. 42 patients required discharge, and the other 29 cases were discharged after improvement. Hematuria, gingival bleeding (oral), and (ear) nasal bleeding were the main symptoms of the disease. There were significant differences in the gender, the causes of poisoning, and the indexes of blood coagulation (PT, APTT, activity). There was a significant correlation between the time of poisoning and the function of blood coagulation and the amount of poison. There was a correlation between the amount of vitamin K1 and the indexes of blood coagulation function, hemoglobin and poison. Vitamin K1 withdrawal time was correlated with the amount of toxicant, which was statistically significant.2 patients did not use vitamin K1 after discharge, and died. Conclusion The patients with unexplained hematuria, (mouth) bleeding gums, (ears) nasal bleeding and other symptoms should be considered anticoagulant rodenticide poisoning. Vitamin K1 is a specific antagonist of anticoagulant rodenticide poisoning. The dosage of vitamin K1 and the time of drug use are positively correlated with the concentration of toxin and prothrombin time, but negatively correlated with prothrombin activity and hemoglobin. The treatment should be based on coagulation function and the concentration of anticoagulant rodenticide gradually adjust the amount of vitamin K1, timely supplement of red blood cells.
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