急性氯气中毒后儿童与成人临床特点的比较

Clinical comparative study of children and adults after acute chlorine exposure

目的探讨儿童与成人在急性氯气中毒后临床特点的区别。方法对急性氯气中毒患者24h内的临床表现、实验室结果及中毒第8天后肺功能检查结果进行回顾性分析。结果儿童与成人急性氯气中毒患者相比，重度中毒患儿的比例高于成人；中毒后24h内胃肠道反应、意识障碍、窦性心动过速、一过性的血压升高、急性呼吸窘迫综合征（ARDS）、呼吸性酸中毒、血白细胞和中性粒细胞升高的发生率等方面，儿童明显高于成人（P〈0．05）；儿童与成人患者呼吸道刺激症状、呼吸困难和血乳酸增多的发生率相比差异无统计学意义（P〉0．05）；中毒第8天，FVC、FEV1（〉80％预计值）儿童与成人相比差异无统计学意义（P〉0．05）。结论儿童急性氯气中毒后临床症状较重，能迅速发展为ARDS；经过及时有效的治疗后，儿童肺功能的恢复早于成人。

Objective To investigate the difference between children and adults in clinical characteristics after acute chlorine exposure. Methods We performed a retrospective study on clinical and laboratory indicators within 24 hours, and pulmonary function tests after 8 days. Results The proportion of severe poisoning in children was higher than those in adults. Within 24 hours, the incidences of gastrointestinal reaction, conscious disturbance, sinus tachycardia, a transient increase in blood pressure, acute respiratory distress syndrome （ARDS）, respiratory acidosis, and the level of leukocyte and neutrophil in children patients were significantly higher than those in adult ones （P 〈 0. 05）. There was no significant difference in respiratory irritation symptoms, dyspnea, the level of blood lactate within 24 hours, and in pulmonary function FVC and FEV1 （ 〉 80% predicted） between child and adult patients after 8 days （P 〉 0.05 ）. Conclusion Children patients with acute chlorine gas inhalation appear more serious clinical symptoms, and develop into ARDS rapidly. After appropriate treatment, the pulmonary function of children patients recover earlier than adult ones.