天津地区2012—2017年燃煤取暖致儿童急性一氧化碳中毒流行病学分析  

Epidemiological analysis of acute carbon monoxide poisoning in children induced by coal burning for home-heating in Tianjin area from 2012 to 2017

作　　者：张进华[1] 杨正[1] 王淑凤[1] 李崇巍[2] Zhang Jinhua;Yang Zheng;Wang Shufeng;Li Chongwei(Department of Rehabilitation,Tianjin Children＇s Hospital,Tianjin 300134,China)

机构地区：[1]天津市儿童医院康复科,天津300134 [2]天津市儿童医院内科,天津300134

出　　处：《中华航海医学与高气压医学杂志》2018年第5期315-318,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的分析天津地区因燃煤取暖导致儿童急性一氧化碳中毒（acute carbon monoxide poisoning, ACOP）的流行病学特征，为ACOP的防控提供科学依据。方法对2012年6月1日－2017年5月31日天津市儿童医院高压氧科收治因燃煤取暖导致ACOP患儿的性别、年龄、所在城区、中毒时间、陪护人中毒情况、开始高压氧（hyperbaric oxygen, HBO）治疗时间等数据进行回顾性分析。结果5年间共收治ACOP患儿381例，因燃煤取暖所致322例（84.51%）。包括男孩181例（56.21%），女孩141例（43.79%）。年龄（4.2±3.3）岁，年龄范围22 d～15岁，其中≤1岁73例（22.67%），1～3岁85例（26.40%），3～6岁91例（28.26%），〉6岁73例（22.67%）。天津主城6区37例（11.49%），近郊5区166例（51.55%），天津远郊5区119例（36.96%）。年平均发病64.40例。集中供热期（11月15日至次年3月15日）内281例（87.27%），供热期外41例（12.73%）。供热期外中毒≤1岁者占29.27%（12/41），高于供热期内≤1岁患儿比例21.71%（61/281），差异有统计学意义（P＝0.004）。夜间发生280例（86.96%）。合并其他家庭成员发病272例（84.47%），家庭成员中毒合计489人。出现症状6 h内开始HBO治疗141例（43.79%），平均每人接受HBO治疗6.1次。结论应在ACOP高发的重点城区、季节和人群中实施宣传和预警，普及ACOP相关常识，推进集中供暖基础设施建设，以减少ACOP的发生。Objective To analyze the epidemiological features of acute carbon monoxide poisoning （ACOP） in children induced by coal burning for home-heating, so as to provide evidence for ACOP prevention and control.Methods A retrospective analysis was made on the medical data of gender, age, dwelling place, poisoning time, intoxication of family members, implementation time of hyperbaric oxygen （HBO） therapy in child patients with ACOP admitted to the Department of HBO of Tianjin Children＇s Hospital from June 1, 2012 to May 31, 2017 due to coal burning for home-heating in Tianjin area from 2012 to 2017.Results In the past 5 years, a total of 381 patients with ACOP were admitted for treatment, including 322 patients intoxicated （84.51%） owing to burning coal for home-heating. Of the 322 patients, 181 were boys （56.21%） and 141 were girls （43.79%）. Age ranged from 22 days to 15 years old, with an average age of 4.2 ± 3.3 years. And of the 322 patients, 73 were younger than 1 year old （22.67%）, 85 were in the age of 1-3 years （26.40%）, 91 were in the age of 3-6 years （28.26%）, and 73 were over 6 years old （22.67%）. As to the area of distribution of ACOP, 37 cases were in 6 main municipal districts of Tianjin, accounting for （11.49%）, 166 cases were in the suburban, accounting for 51.55% and 119 cases were in exurban of the city, accounting for 36.96%, with an annual average incidence of 64.4 cases. Most cases （281, 87.27%） occurred in the centralized heating period, i. e. from Nov 15 to Mar 15 nest year, and relatively few cases （41, 12.73%） occurred beyond the heating period. Beyond the heating period, the percentage of ACOP patients younger than 1 year was 29.27% （12/41）, and statistical significance could be noted when comparisons were made （P=0.004）. There were 280 ACOP patients （86.96%） who had ACOP at night （86.96%）, and there were 272 patients （84.47%） whose family members also had ACOP, with a total 489 family members having ACOP. One hundred and fo

关 键 词：急性一氧化碳中毒 流行病学 高压氧 儿童 天津 

分 类 号：R725.1[医药卫生—儿科] R181.3[医药卫生—临床医学]