粤港两地口服中毒患者急诊胃肠道清除方法对比分析

Difference of Gastrointestinal Poison Elimination for Patients with Oral Poisoning in Guangdong Province and HK

目的分析广东省与香港急诊室收治的口服中毒案例胃肠道毒物清除方法的差异,为广东省结合地区中毒特点制定更加国际化口服中毒急救流程提供依据。方法通过分析香港文献和互联网发放调查表,收集粤港两地急诊室收治的口服中毒患者资料,比较两地毒物种类、胃肠道清除方法和疗效。结果粤港两地急诊室收治口服中毒患者服用的毒物种类差异有统计学意义,已知毒物种类中香港患者主要服用安眠药(23.99%)和止痛药(17.99%),而广东省患者主要是安眠药(34.96%)、有机磷农药(30.02%)和灭鼠药(10.94%)。患者处置方式差异有统计学意义,香港急诊室约59.92%只采用支持疗法,不使用胃肠道清除方法,而在胃肠道清除方法中大多数使用单独口服活性炭(32.51%);广东省急诊室常用方法是单独洗胃(67.98%)。两地患者疗效差异无统计学意义(P>0.05)。结论广东省的口服中毒患者多采用单独洗胃清除毒物,香港多采用单独口服活性炭;故急救流程可参照国际公认标准,结合地区中毒特点制定,并定时更新,活性炭在国外和香港运用广泛且疗效肯定,可作为借鉴。

Objective To analyze the difference of gastrointestinal poison elimination for patients with oral poisoning in Guangdong Province and HK and to provide reference for establishing emergency treatment flow for oral poisoning in Gnangdong Province. Methods Data of patients with oral poisoning were collected through analysis of literature in HK and the investigation with questionnaires conducted in the Internet then types of poisons, approaches of gastrointestinal poison elimination and effects were analyzed. Results In HK, major poisons included hypnotic （23.99%） and analgesic （17.99%） and in Guangdong Province, hypnotic （34.96%）, organophosphorus pesticide （30.02%） and raticide （10.94%）. The difference of poisons types and approaches of gastrointestinal poison elimination indicated statistical significance. In HK, major approach of poison elimination was supporting treatment, accounting for about 59.92% and the most frequently-seen approach of gastrointestinal poison elimination was taking activated carbon orally （32.51%） while in Guangdong Province gastric lavage （67.98%）. The effect difference in HK and Guangdong Province revealed no statistical significance （P〉O.05）. Conclusion It is recommended emergency treatment flow in Guangdong Province be established and updated on the basis of international standard and local poison features. Activated carbon is widely applied in HK and abroad which is effective and worth to be popularized.