1965例急性中毒多中心前瞻性临床流行病学调查  

A multi-center prospective clinical study on the epidemiology of I 965 patients with acute poisoning

作　　者：乔莉 张劲松 陈建荣[2] 刘励军[3] 徐继扬 孙虹[5] 杜叶平[6] 田质光 马建军[8] 杨如山 董建成[10] 蒋雷 季学丽 沈君华[2] 赵旭明[3] 孙青松[5] 马娟[6] 

机构地区：[1]南京医科大学第一附属医院急诊医学科,南京210029 [2]南通市第一人民医院急诊科,江苏省南通226001 [3]苏州大学附属第二医院急诊科,江苏省苏州215004 [4]苏北人民医院急诊科,江苏省扬州225001 [5]淮安市第一人民医院急诊科,江苏省淮安223300 [6]淮安市第二人民医院急诊科,江苏省淮安223300 [7]徐州市第三人民医院,江苏省徐州221005 [8]南通市第四人民医院,江苏省南通226005 [9]如皋市人民医院,江苏省如皋226500 [10]南通大学数字医学研究所,江苏省南通226001

出　　处：《中华急诊医学杂志》2016年第11期1376-1380,共5页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（81571875,81671899）;江苏省科技厅重点病种规范化诊疗研究（BL2014088）;江苏省自然科学基金（BK20131444）;江苏省高校优势学科建设工程资助项目（JX10231801）

摘　　要：目的调查急性中毒患者的临床流行病学特征。方法独立设计调查登记表，采用多中心、前瞻性病例调查方法，收集并分析2015年6月至2016年9月江苏省9所医院急诊科就诊的急性中毒患者的临床资料。结果1965例中毒患者中，男性893例，女性1072例，院内病死率为1．73％；最常见的中毒原因为自杀（54．96％）；最常见的毒物种类为农药（35．83％）和药物（23．16％），分别占中毒死亡病例的70．59％和8．82％；最常见的毒物为百草枯（12．37％）；最常见的中毒途径为口服（93．18％），洗胃干预者占所有口服中毒患者的38．27％。22．34％的患者接受了拮抗剂治疗，12．62％的患者接受了糖皮质激素治疗，18．83％的患者接受了血液灌流治疗，1．37％的患者接受了血液透析。结论研究显示综合型医院中，农药中毒的发生率和病死率最高，口服中毒是最常见的中毒途径。Objective To investigate the epidemiological characteristics of acute poisoning patients. Methods After the survey registration form was designed independently, a multi-center prospective study of patients with acute poisoning admitted into Emergency Department was carried out from May 2015 to September 2016 in 9 hospitals in Jiangsu Province. Results A total of 1 965 acute poisoning patients consisting of 893 males and 1 072 females were enrolled. Of them, there was 1.73% in-hospital mortality. Among them, the major cause of poisoning exposure was suicide （54.96%）; The two leading toxic substances were pesticides （35.83%） and medicines abused （23.16%）, which constituted the mortalities of 70. 59% and 70. 59%, respectively. Paraquat （ 12. 37% ） was the most commonly poisoning exposure. Ingestion was the predominant access route of poisoning exposure in 93. 18% of all poisoning cases, and 38. 27% of those cases were treated with gastric lavage. Other kinds of treatment were utilizations of antagonists （22. 34% ） and glucocorticoid （ 12. 62% ）, and hemoperfusion （ 18.83% ）, and hemodialysis （ 1.37% ）. Conclusion Pesticide remains the most common poisons and results the highest mortality of all substances involved in poisoning exposure cases in general hospitals in Province. Ingestion is the most common route in all poison cases.

关 键 词：急性中毒 流行病学 多中心 前瞻性研究 

分 类 号：R595[医药卫生—内科学]