急性中毒事件375例临床分析

Clinical analysis of 375 patients with acute poisoning

目的通过对各种急性中毒性疾病的流行病学回顾调查，分析其特点，以便更好地提高控制和救治中毒的能力。方法蚌埠医学院第一附属医院急诊内科病房成立1年来收治的急性中毒患者，对患者年龄、性别、职业、中毒途径、毒物种类、中毒规律、中毒并发多器官功能衰竭（MOF）及其预后进行临床分析。结果375例急性中毒患者女性多于男性（1．53：1）；年龄以20—49岁最多（66．4％）；职业分布以农民最多（92．53％），其次为城市居民（4．53％）、工人（2．13％）、学生（0．81％）；口服自杀是主要原因，少数为误服或皮肤接触中毒；毒物种类以农药为主，百草枯、有机磷及其他低毒类的除草剂占居前3位；发病季节以6，7，8，9月份最多；其中71例发生MOF（18．93％）；MOF的原发病因，主要为百草枯中毒（70．42％），其次为有机磷中毒（15．49％）；375例急性中毒治愈191例（50．93％）、好转117例（31．2％）、未愈35例（9。33％）、死亡32例（8．53％）；X2检验不同毒物种类中毒病死率差异有统计学意义（P〈0．01）。结论要重视广大民众心理健康及预防保健教育，建立中毒急救的绿色通道，完善各种中毒的诊疗程序，提高医务人员的抢救水平。

Abstract ：Objective Retrospective investigation on a variety of acute toxic disease epidemiology,analyze its characteris- tics, in order to better improve the control and treatment of poisoning. Methods The clinical analysis of age, gender, oc- cupation, route poisoning, poison species, poisoning law, poisoning complicated by MOF and prognosis in the patients with acute poisoning admitted to the ward was conducted. Results 375 cases of acute poisoning patients with more women than men（ 1.53： 1 ） ;maximum age of 20 -49 years old （66.4%） ;occupational distribution to farmers up to（92.53 % ） , followed by urban residents（4.53% ） ,workers（2.13% ） ,students（0.81% ） ;oral suicide was the main reason for the in- gestion or skin contact with a small number of poisoning;toxic species dominated by pesticides,paraquat,organic phos- phorus and other toxic herbicides tired of the top three;seasonal incidence of up to 6th,Tth,Sth and 9th month of a year; including 71 cases occurred MOF （ 18.93% ） ;MOF＇ s primary disease： mainly for paraquat poisoning （70.42%） , fol- lowed by organophosphate poisoning（ 15.49% ） ;with 375 cases of acute poisoning cured 191 cases（50.93% ） ,improved in 117 cases （ 31.2% ）, healed in 35 cases （ 9.33 % ）, 32 patients died （ 8.53 % ） ; chi-square test different types of toxic poisoning mortality rates were significantly different（ P 〈 0.01 ）. Conclusion The general public should pay attention to mental health and preventive health education, the establishment of the green channel of Poisoning, and improvement vari- ous poisoning treatment program.