儿童口服毒物中毒173例临床回顾性分析  

Retrospective analysis of 173 cases of oral poisoning in children

作　　者：李玉品 马杰娜 杨洋[1] 江逊[1] 王宝西[1] 虎崇康 Li Yupin;Ma Jiena;Yang Yang;Jiang Xun;Wang Baoxi;Hu Chongkang(Department of Pediatrics,the Fourth Military Medical University in Tangdu Hospital,Xi′an 710038,China)

机构地区：[1]中国人民解放军空军军医大学唐都医院儿科,西安710038

出　　处：《中国小儿急救医学》2019年第11期825-829,共5页Chinese Pediatric Emergency Medicine

摘　　要：目的 分析探讨儿童口服毒物中毒的社会因素及临床特点,为预防和治疗儿童中毒提供参考.方法 对2017年1月至12月在空军军医大学唐都医院儿科诊治的173例口服毒物中毒患儿的临床资料进行回顾性分析.结果 毒物种类农药、杀虫药中毒居首位(68例,39. 31%);不同毒物中毒临床表现多样;城乡分布以农村为主(118例,68. 21%),其中农村中留守儿童有103例(87. 29%);1年内发病人数变化城市波动较小,3月为小高峰,农村波动较大,7月为大高峰;城市患儿以口服内服药中毒为主(34例,61. 82%),农村患儿以口服农药、杀虫药中毒为主(64例,54. 24%);性别分布以男童为主(101例,58. 38%),年龄上幼儿期最高发( 97 例,56. 07%);服毒原因主要有儿童误服( 123 例, 71. 10%),家长不慎喂服(24例,13. 87%),年长儿因情绪因素自行服用(26 例,15. 03%)三类;治疗方法依据毒物种类及中毒时间不同采用洗胃、导泻、灌肠等治疗,及时使用特效解毒药及对症治疗也是治疗的关键.结论 儿童口服毒物中毒农村形势更为严峻,尤其是农村留守儿童,幼儿期最为高发,口服农药、杀虫药和内服药情况最为突出,误服是最主要原因,预防应加强家庭毒物管理,治疗根据毒物种类和服毒时间而异.Objective To analyze and discuss the social factors and clinical characteristics of oral poisoning in children,so as to provide reference for preventing and treating children poisoning.Methods The clinical data of 173 pediatric patients with oral poisoning diagnosed and treated in Department of Pediatrics,the Fourth Military Medical University in Tangdu Hospital from January to December 2017 were retrospectively analyzed.Results Pesticide and insecticide poisoning topped the list(68 cases,39.31%)and the clinical manifestations of different poisons were varied.Geographically,the urban and rural distribution was mainly rural(118 cases,68.21%),among which 103 cases(87.29%)were left-behind children in rural areas.Within one year,the number of urban children fluctuated slightly,with a small peak in March and the number of rural children fluctuated greatly,with a large peak in July.In addition,urban children were mainly poisoned by oral internal medicine(34 cases,61.82%),while rural children were mainly poisoned by oral pesticide and insecticide(64 cases,54.24%).The gender distribution was mainly male(101 cases,58.38%),with the highest incidence in early childhood(97 cases,56.07%).The main reasons for taking poison included children′s misadministration(123 cases,71.10%),parents′accidental feeding(24 cases,13.87%),and elder children′s self-administration due to emotional factors(26 cases,15.03%).The treatment methods were gastric lavage,emetic stimulation and enema according to the type and time of poisoning of administration,and timely use of specific antidote and symptomatic treatment was also the key to treatment.Conclusion The situation is more serious in rural areas of oral poisoning in children,especially for left-behind children in rural areas,who are at the highest incidence in early childhood.Oral pesticides,insecticides and oral drugs are the most prominent,and misadministration is the main reason.Family poison management should be strengthened for prevention,and treatment should vary according to the ty

关 键 词：儿童 口服 毒物 中毒 

分 类 号：R59[医药卫生—内科学]