Paraquat has always been a commonly used insecticide in China, but it is very common for such accidental patients to occur, and the lethality of such diseases is high, and the means and methods of diagnosis and treatment are currently less, and numerous medical forums have been searched for on such diseases. The progress of treatment of paraquat poisoning in China includes: 1. Pre-hospital first aid Once diagnosed, immediately irrigate the stomach and intestines with soapy water repeatedly, and stimulate the throat to induce vomiting and wash away the skin; take oral adsorbent or mucus (clay) as soon as possible. 2. In-hospital first aid There is no special treatment, and emergency treatment should be given regardless of whether there are symptoms or not. ①Stop the absorption of poison Gastric lavage is an important measure, with alkaline liquid gastric lavage, after lavage whole intestine lavage and oral adsorbent bleach (Fuller’s ealth) and bentonite (bentonite), activated charcoal and laxative, the usage is: 20% bleach (trade name Similac) suspension 300ml, activated charcoal 60g/20% mannitol 100-150ml, magnesium sulfate 15g, alternating every 2-3 hours for a week. ②Accelerate the excretion of toxic substances Diuretic and hemodialysis, blood perfusion, the latter is more effective and should be used as early as possible until paraquat cannot be measured in body fluids. ③Stop the damage of poison to the tissues of insulin compete with the receptors bound in the lungs; vitamin E, C, super large oxide dismutase, selenium, niacin destroy oxygen free radicals; hydrocortisone, dexamethasone and immunosuppressant cyclophosphamide, azathioprine, fluorouracil reduce the effect of pulmonary fibrosis; potassium aminobenzoate, colchicine, radiation therapy dissolve pulmonary fibrin. All of the above drugs can be used. Recently, it is believed that gastrointestinal injection of ethanol can reduce the death rate of paraquat poisoning. Scholars in China have applied compound salvia liquid (30-40mg/d), scopolamine (2.4-10mg/d) and dexamethasone (25mg/d) to improve microcirculation, scavenge oxygen free radicals, maintain organ function and reduce the death rate with good efficacy; there are also the use of desferrioxamine (100mg/kg.24h ) and acetylcysteine (300mg/kg.d) have been successfully used to save patients. Oxygen therapy Oxygen therapy can accelerate the formation of oxygen radicals and promote death, so it is generally given only when the arterial partial pressure of oxidation is <40 mmHg at a concentration of >21% oxygen. Other treatment methods that can be used: Wang Jun t the Intensive Care Unit of Nanping First Hospital can use peritoneal dialysis or hemodialysis for patients who develop acute renal failure, but dialysis has no effect of increasing the excretion of paraquat from the body. Hemoperfusion has been used as a treatment method for many years, but the effectiveness of this method is still controversial. Although activated carbon columns are very effective in removing paraquat from the blood, the distribution of paraquat into the surrounding tissues is rapid because of the rapid distribution of paraquat into the tissues and the relatively slow re-entry of paraquat from the tissues back into the blood. That is, the amount of poison in the tissues is determined by the blood concentration in the early stages of poisoning. The following factors should be taken into consideration when considering whether to use hemoperfusion in paraquat poisoning patients: 1 The patient has taken a near lethal dose of paraquat, or has a 20-70% chance of survival, and within a few hours of ingestion, in which case the use of hemoperfusion is helpful for recovery. 2 The patient has ingested many times more than the lethal dose, or the prognosis is poor according to the survival curve, in which case the use of hemoperfusion is not helpful for recovery. recovery is not helpful.3 Continuous application of hemoperfusion is not useful for saving lives, but may prolong survival. Prevention and treatment of pulmonary fibrosis Patients with moderate toxicity who do not die early from multiple organ failure or esophageal perforation tend to develop pulmonary fibrosis and die of respiratory failure within a few weeks. Several treatment options are available to try to stop this process. Cyclophosphamide and steroid hormone therapy There are several studies focusing on the application of cyclophosphamide and steroid hormone application. addo and POON-KING (1986) treated the first 2 patients with paraquat poisoning with cyclophosphamide (5 mg/kg/day, 4 g total) and dexamethasone (8 mg every 8 hours for 2 weeks) and 72% of patients Survival, however, of the 25 patients with plasma test data, paraquat was not measured in the blood of 7 survivors, and only 6 of the other 18 patients with the lowest plasma concentrations survived. lin et al. (1999) reported knowledge of a clinical study of 142 patients treated with cyclophosphamide (1 g/day for 3 days) and methylprednisolone (1 g/day for 3 days) at intervals, with patients randomized to groups , 71 patients with fulminant poisoning died within one week, without any difference between the cyclophosphamide group and the control group. In the moderate to severe poisoning group, only 4 of 22 patients treated with cyclophosphamide died, while the control group did have 16 of 28 deaths. This study did not measure paraquat concentrations in patients’ plasma, but the authors mentioned that it was the grouping of patients based on the thiosulfate test that was matched using the severity of the patients. However, controversy over the effectiveness of cyclophosphamide-methylprednisolone treatment is reflected in the prospective study by PERRIENS (1992) et al. Their results showed no difference in the morbidity and mortality rates between the control group (14 patients received standard treatment) and the experimental group (33 patients received high doses of cyclophosphamide and dexamethasone). I treated 16 patients with this method between 1994 and 1997, with 9 deaths compared to 22 deaths out of 42 in the control group, with no significant difference (P > 0.5) (see Chinese Journal of Occupational Diseases of Labor Health, 1998, No. 12). Thus, there is no final conclusion on the effectiveness of this therapy. However, there is no evidence that this method reduces mortality. Although several lung transplants have been performed, this is the only one that has been reported to be successful (LICKEK, 1998). The surgery was performed 5 weeks after exposure to paraquat (during which time the patient was supported by mechanical ventilation to find a donor). Supportive therapy also included hemodialysis until paraquat was not detectable in the blood or dialysis fluid. This patient is still alive 20 months after the lung transplant. Clinical approaches have been used including antioxidants (vitamins C and E) and peroxidase to reduce the toxicity of free radicals. n–acetylcysteine is used to increase intracellular glutathione desferrioxamine is used to chelate iron ions that act as catalysts for hydroxyl radicals. Cardiotrope is used to block the binding of paraquat to the lungs. Oxygen containing nitric oxide is inhaled to improve gas exchange in the lungs.