急性中毒住院患儿1005例临床回顾分析  

A retrospective study of 1005 children hospitalized for acute poisoning

作　　者：姜曼[1,2] 李秋[1] 

机构地区：[1]重庆医科大学附属儿童医院肾脏免疫科,重庆400014 [2]深圳市儿童医院肾脏免疫科,广东深圳518000

出　　处：《中国实用儿科杂志》2014年第3期218-221,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨小儿急性中毒在中毒原因、中毒途径、年龄构成等方面的特点及变化。方法回顾性分析重庆医科大学附属儿童医院2000—2011年1005例急性中毒患儿的住院资料,总结其临床特点。结果 1005例急性中毒患儿中,1～4岁患儿多见(50.02%)。药物中毒(26.07%)上升至首要中毒原因,以神经精神类药物(32.06%)为主,主要发生于≤3岁患儿(P<0.001),以及来自城镇患儿(P<0.001)。后依次为食物中毒(19.50%)、生物毒(16.92%)及农药中毒(14.73%)。农村患儿动物毒、农药及鼠药中毒明显多于城镇(P<0.001、P<0.001、P<0.05)。误服毒物(53.44%)为儿童急性中毒主要途径。自服毒物(48例)主要发生在>6岁患儿。急性中毒主要临床表现包括消化道症状(42.89%)、神经系统症状(31.74%)、呼吸道症状(11.14%)及肾功能衰竭(4.47%)。治疗有效443例(40.08%),好转519例(51.64%),未愈29例(2.89%),死亡14例(1.39%)。结论儿童急性中毒原因和途径因儿童年龄和家庭背景而异。儿童急性中毒临床表现多样,早期诊断治疗可提高治疗效果。Objective To investigate the new changes in the causes, the routes and the age composition of acute poisonings in children. Methods The 1005 cases of acute poisonings which were admitted to the Children＇s Hospital of Chongqing Medical University were retrospectively evaluated and divided into groups by age or by different family backgrounds. Different causes and routes of poisonings in different groups, the clinical manifestations, treatments and prognosis were retrospectively analyzed. Results Acute intoxication mainly happened in the children aged 1-4 （50.02%） in the 1005 cases. Pharma- cological poisoning （26.07%） rose to be the top reason of poisonings, which was mainly composed of neurological and psychiatric drugs （32.06%）, and happened in the children ≤ 3 years old（P〈0.001 ） and urban children （P〈0.001）. Rural children with animal bites and stings, pesticide poisonings and rodenticide poisonings were more than the urban children（P〈 0.001, P〈0.001, P〈0.05）. Accidental poison was the main route in pediatric acute poisonings （53.44%）. The intentional poisonings mainly happened in the children more than 6 years old. Acute intoxication was involved in gastrointestinal system （42.89%）, nervous system （31.74%）, respiratory system （11.14%） and kidney （ 4.47% ）. After treatments, 443 cases （40.08%） were effective, 519 cases （51.64% ） improved, 29 eases （2.89%） not improved and there were 14 deaths （ 1.39% ）. Conclusions The causes and the routes of poisonings in children differ by ages and origins. Manifestations of acute poisonings are multiple. Early diagnosis and management may improve the outcome.

关 键 词：急性中毒 儿童 住院 病案系统 计算机化 

分 类 号：R72[医药卫生—儿科]