蚌埠地区儿童427例急性中毒的临床分析

胡庆岩; 丁周志; 赵冰; 付连国; 徐惠

doi:10.16766/j.cnki.issn.1674-4152.001829

蚌埠地区儿童427例急性中毒的临床分析

doi: 10.16766/j.cnki.issn.1674-4152.001829

蚌埠医学院第一附属医院儿科，安徽蚌埠 233004

基金项目:

安徽省高校优秀青年人才支持计划重点项目 gxyqZD2017063

详细信息

通讯作者:
丁周志，E-mail：719295719@qq.com

中图分类号: R595 R174 R179
计量
- 文章访问数: 180
- HTML全文浏览量: 97
- PDF下载量: 3
- 被引次数: 0
出版历程
- 收稿日期: 2020-11-19
- 网络出版日期: 2022-02-19

Clinical analysis of 427 cases of acute poisoning in children in Bengbu area

Department of Pediatrics, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探究儿童急性中毒的临床特点，为本地区制定儿童急性中毒防治措施提供参考。方法取回顾性调查方法，收集急性中毒住院患儿的临床资料，以儿童各年龄发育阶段作为分组依据，统计软件归纳整理急性中毒患儿的性别、发病年龄、中毒种类、中毒地点、中毒原因及途径、居住环境、发病季节，中毒发生后至入院的时间、院前急救、治疗转归等信息，一般资料分布采用构成比统计描述，组间比较采用χ²检验，分析急性中毒患儿的临床特点。结果在427例急性中毒患儿中，男童234例(54.8%)，女童193例(45.2%)；婴儿期急性中毒6例(1.4%)，幼儿期及学龄前期共369例(86.4%)，学龄期以上共52例(12.2%)；农村地区患儿共286例(67.0%)，中毒种类前3位依次为农药112例(39.2%)、药物80例(28.0%)、杀鼠剂中毒63例(22.0%)；城市患儿共141例(33.0%)，中毒种类前3位为药物76例(53.9%)、生活化学品20例(14.2%)、农药16例(11.3%)；中毒地点于家中411例(96.3%)；发病季节上，春夏季节发病249例(58.3%)；急性中毒患儿中98.1%经过积极治疗后恢复良好。结论本地区儿童急性中毒以幼儿期、学龄前期儿童最为多见，经消化道误服药物、农药、杀鼠剂在本地区患儿中最为突出，应在春夏季节加强农村基层毒物管理及监护人安全宣教，以减少儿童急性中毒事件的发生。
- 急性中毒 /
- 发病原因 /
- 防范策略 /
- 儿童
Abstract: Objective To explore the clinical characteristics of acute poisoning in children and to provide reference for the prevention and treatment of acute poisoning in children in this area. Methods Using the method of retrospective investigation, the data of hospitalized children with acute poisoning were collected and divided into groups according to the developmental stages of children of different ages. The statistical software summarized and sorted out the information of sex, age of onset, type of poisoning, location of poisoning, cause and route of poisoning, living environment, season of onset, time from poisoning to admission, pre-hospital first aid, treatment outcome and so on. The general data distribution was described by constituent ratio statistics, and the chi-square test was used to analyze the clinical characteristics of children with acute poisoning. Results Among the 427 cases of acute poisoning, 234 (54.8%) were boys and 193 (45.2%) were girls, 6 (1.4%) were acute poisoning in infancy, 369 (86.4%) were in infancy and preschool, and 52 (12.2%) were above school age. There were 286 cases (67.0%) in rural areas, the top three types of poisoning were 112 cases of pesticides (39.2%), 80 cases of drugs (28.0%), 63 cases of rodenticide poisoning (22.0%), and 141 cases of urban cases (33.0%). The top three types of poisoning were 76 cases of drugs (53.9%), 20 cases of household chemicals (14.2%) and 16 cases of pesticides (11.3%). The site of poisoning was 411 cases (96.3%) at home. In the onset season, 249 cases (58.3%) occurred in spring and summer, 98.1% of the children with acute poisoning recovered well after active treatment. Conclusion Acute poisoning of children in this area is most common in early childhood and preschool children, and misadministration of drugs, pesticides and rodenticide through digestive tract is the most prominent in this area. Rural grass-roots poison management and safety education of guardians should be strengthened in spring and summer to reduce the occurrence of acute poisoning in children.
- Acute poisoning /
- Cause of disease /
- Preventive strategy /
- Children

HTML全文

表 1 患儿急性中毒种类构成分布[例(%)]

项目		农药	药物	杀鼠剂	食物	生活化学品	CO	有毒植物	其他	χ²值	P值
性别	男	76(32.5)	86(36.8)	38(16.2)	8(3.4)	14(6.0)	8(3.4)	3(1.3)	1(0.4)	3.439	0.843
	女	52(26.9)	70(36.3)	38(19.7)	5(2.6)	13(6.7)	11(5.7)	3(1.6)	1(0.5)
年龄组	婴儿组	1(16.7)	3(50.0)	1(16.7)	0(0.0)	1(16.7)	0(0.0)	0(0.0)	0(0.0)	155.398	< 0.001
	幼儿组	77(25.2)	134(43.9)	65(21.3)	2(0.7)	21(6.9)	2(0.7)	3(1.0)	1(0.3)
	学龄前组	32(50.0)	11(17.2)	9(14.1)	3(4.7)	3(4.7)	4(6.3)	2(3.1)	0(0.0)
	学龄组	12(33.3)	3(8.3)	1(2.8)	7(19.4)	2(5.6)	9(25.0)	1(2.8)	1(2.8)
	青春期组	6(37.5)	5(31.3)	0(0.0)	1(6.3)	0(0.0)	4(25.0)	0(0.0)	0(0.0)
住地	城市	16(11.3)	76(53.9)	13(9.2)	4(2.8)	20(14.2)	9(6.4)	3(2.1)	0(0.0)	74.595	< 0.001
	农村	112(39.2)	80(28.0)	63(22.0)	9(3.1)	7(2.4)	10(3.5)	3(1.0)	2(0.7)
季节	春	65(48.5)	36(26.9)	22(16.4)	3(2.2)	6(4.5)	0(0.0)	2(1.5)	0(0.0)	89.851	< 0.001
	夏	41(35.7)	46(40.0)	9(7.8)	3(2.6)	9(7.8)	5(4.3)	1(0.9)	1(0.9)
	秋	10(11.0)	39(42.9)	23(25.3)	6(6.6)	10(11.0)	3(3.3)	0(0.0)	0(0.0)
	冬	12(13.8)	35(40.2)	22(25.3)	1(1.1)	2(2.3)	11(12.6)	3(3.4)	1(1.1)

下载: 导出CSV

表 2 急性中毒患儿中毒原因分布[例(%)]

项目	类别	误服	误食	药物过量	自杀	身体接触	吸入中毒	医源性	χ²值	P值
性别	男	196(83.8)	11(4.7)	6(2.6)	2(0.9)	2(0.9)	15(6.4)	2(0.9)	5.996	0.424
	女	151(78.2)	8(4.1)	5(2.6)	4(2.1)	7(3.6)	16(8.3)	2(1.0)
年龄组	婴儿组	4(66.7)	0(0.0)	0(0.0)	0(0.0)	0(0.0)	0(0.0)	2(33.3)	334.507	< 0.001
	幼儿组	283(92.8)	5(1.6)	9(3.0)	0(0.0)	2(0.7)	5(1.6)	1(0.3)
	学龄前组	48(75.0)	5(7.8)	2(3.1)	0(0.0)	2(3.1)	7(10.9)	0(0.0)
	学龄组	9(25.0)	8(22.2)	0(0.0)	1(2.8)	4(11.1)	13(36.1)	1(2.8)
	青春期组	3(18.8)	1(6.3)	0(0.0)	5(31.3)	1(6.3)	6(37.5)	0(0.0)
住地	城市	111(78.7)	7(5.0)	9(6.4)	1(0.7)	0(0.0)	11(7.8)	2(1.4)	17.904	0.006
	农村	236(82.5)	12(4.2)	2(0.7)	5(1.7)	9(3.1)	20(7.0)	2(0.7)
季节	春	120(89.6)	5(3.7)	6(4.5)	0(0.0)	2(1.5)	0(0.0)	1(0.7)	41.257	0.001
	夏	93(80.9)	4(3.5)	0(0.0)	0(0.0)	3(2.6)	13(11.3)	2(1.7)
	秋	71(78.0)	6(6.6)	2(2.2)	4(4.4)	3(3.3)	5(5.5)	0(0.0)
	冬	63(72.4)	4(4.6)	3(3.4)	2(2.3)	1(1.1)	13(14.9)	1(1.1)

下载: 导出CSV

表 3 急性中毒患儿中毒后送医时间分布[例(%)]

中毒后就医时间(h)	例数	城市	农村
< 2	140(32.8)	62(44.0)	78(27.3)
2~ < 6	197(46.1)	59(41.8)	138(48.2)
6~ < 12	57(13.3)	13(9.2)	44(15.4)
≥12	33(7.7)	7(5.0)	26(9.1)

下载: 导出CSV

参考文献(19)

[1]	World Health Organization. Monitoring health for the SDGs, Sustainable development goals[R]. World Health Statistics 2017(2017-05-17)[2020-11-07]. https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/world-health-statistics
[2]	翁翠叶, 金微瑛, 潘国权, 等. 118例重症监护室急性中毒患儿临床分析[J]. 医学研究杂志, 2016, 45(1): 134-137. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYZ201601038.htm
[3]	国家食品药品监督管理总局南方医药经济研究所, 广州标点医药信息股份有限公司. 2016年儿童用药安全调查报告白皮书[R]. 北京: 首届儿童安全用药传播与发展大会, 2016.
[4]	卢亚亚, 娄丹. 洛阳地区675例急性中毒儿童特征分析[J]. 实用预防医学, 2019, 26(4): 471-473. doi: 10.3969/j.issn.1006-3110.2019.04.024
[5]	王永霞, 李月花. 中毒住院患儿494例相关因素分析[J]. 中国实用医刊, 2017, 44(17): 99-102. doi: 10.3760/cma.j.issn.1674-4756.2017.17.031
[6]	Z'GAMBO J, SIULAPWA Y, MICHELO C. Pattern of acute poisoning at two urban referral hospitals in Lusaka, Zambia[J]. BMC Emerg Med, 2016, 16(1): 1-8. doi: 10.1186/s12873-015-0064-z
[7]	SHARMA S, DEWAN A, SINGH G. Toxico-vigilance-an inevitable prerequisite to keep a watch on toxins around you[J]. J Forensic Leg Med, 2017, 45: 32-35. doi: 10.1016/j.jflm.2016.11.005
[8]	曹雪笛, 高恒妙, 廖琨, 等. 儿童急性中毒流行病学单中心前瞻性研究[J]. 中国小儿急救医学, 2015, 22(11): 758-761. doi: 10.3760/cma.j.issn.1673-4912.2015.11.005
[9]	杨奔, 胡利华, 邢梅, 等. 644例儿童误服药物特点分析[J]. 中国药房, 2018, 29(1): 135-137. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYA201801033.htm
[10]	胡利华, 张琬迎, 李惠茹, 等. 2014年中国城市居民家庭药箱及儿童用药行为调查及分析[J]. 实用药物与临床, 2016, 19(2): 257-260. https://www.cnki.com.cn/Article/CJFDTOTAL-LYLC201602034.htm
[11]	LEE J, FAN N C, YAO T C, et al. Clinical spectrum of acute poisoning in children admitted to the pediatric emergency department[J]. Pediatr Neonatol, 2019, 60(1): 59-67. doi: 10.1016/j.pedneo.2018.04.001
[12]	何芳. 小儿急性中毒296例临床分析[J]. 中国小儿急救医学, 2015, 22(10): 725-727. doi: 10.3760/cma.j.issn.1673-4912.2015.10.014
[13]	张含花, 方莹, 任晓侠, 等. 儿童急性中毒临床分析(附521例报告)[J]. 中国实用儿科杂志, 2018, 33(8): 622-625. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201808017.htm
[14]	孙青松, 孙虹, 赵红梅, 等. 424例急性中毒单中心前瞻性临床流行病学调查[J]. 临床急诊杂志, 2018, 19(5): 346-350. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC201805019.htm
[15]	TOBAIQY M, ASIRI B A, SHOLAN A H, et al. Frequency and management of acute poisoning among children attending an emergency department in Saudi Arabia[J]. Pharmacy, 2020, 8(4): 189. doi: 10.3390/pharmacy8040189
[16]	LAND M E, WETZEL M, GELLER R J, et al. Analysis of 207, 543 children with acute opioid poisonings from the United States National Poison Data System[J]. Clin Toxicol, 2020, 58(8): 829-836. doi: 10.1080/15563650.2019.1691731
[17]	安媛, 王娟, 邓阳彬, 等. 285例急性中毒患儿相关因素分析[J]. 中国妇幼健康研究, 2016, 27(1): 73-75. doi: 10.3969/j.issn.1673-5293.2016.01.025
[18]	HAUPTMAN M, BRUCCOLERI R, WOOLF A D. An update on child-hood lead poisoning[J]. Clin Pediatr Emerg Med, 2017, 18(3): 181-192. doi: 10.1016/j.cpem.2017.07.010
[19]	TIPLAMAZ S, KIRKPINAR E, ÍNANICI M A. Acute poisoning in children; Evaluation of cases admitted to Marmara University Hospital in 2015[J]. Marmara Med J, 2018, 31: 120-125. http://www.researchgate.net/publication/328639445_Acute_poisoning_in_children_Evaluation_of_cases_admitted_to_Marmara_University_Hospital_in_2015