2746例急性中毒患者流行病学调查

Epidemiological study of 2746 acute poisoning patients

目的：通过回顾急性中毒患者的流行病学资料,分析患者的临床特点,为临床救治和社会预防干预提供依据。方法：选取2012-01-01-2014-12-31经我院急诊科救治的全部中毒患者为本次研究对象。由受过培训的专人填写中毒表格,内容包括性别、年龄、职业、患者来源、发生时间及地点、毒物种类、摄入剂量、中毒途径、临床表现、急诊处理方式、诊断和转归等。结果：3年间我院急诊科共收治急性中毒患者2 746例,女性占61.3%,中毒患者年龄分组中以21-30岁组所占比例最高,已婚患者所占比例高于单身患者。最常见的毒物是药物（64.0%）,以镇静安眠药为主;第2、3位分别是农药（9.2%）和酒精中毒（8.2%）。百草枯和新型毒品中毒有显著增多趋势。最常见的中毒途径是口服中毒,自杀企图的患者中,女性占70.7%。8月和9月是中毒高发季节。中毒患者病死率为4.5%,农药中毒死亡占第1位,其中百草枯中毒死亡110例,占中毒死亡患者的89.4%。结论：药物、农药和酒精中毒是导致中毒的常见毒物。新型毒品中毒有显著增高趋势,百草枯中毒预后较差,因此需要加强这些毒物的发病机制和临床救治的研究。女性自杀仍是导致急性中毒的主要原因,年轻女性应该成为防止中毒的社会干预关注重点。

Objective：The epidemiology data of acute poisoning patients were retrospectively analyzed.The clinical characteristics of patients were analyzed and the results will provide the help for clinical treatment and social prevention strategy.Method：From January 1,2012 to December 31,2014,all acute poisoning patients who visited the emergency department of our university hospital were included.The form including gender,age,profession,patient source,poison time,exposure site,substance of poison,dosage,exposure route,clinical manifestation,emergency treatment,diagnosis and prognosis,was filled by trained personnel.Result：There were 2 746 patients with acute poisoning who visited our emergency department.Women accounted for 61.3%.21 to 30year old patient accounted for the highest proportion.Married patients exceed single ones.Medicinal drugs were the most common cause of poisonings（64%）and sedative hypnotic drugs were the most frequent drug ingested,followed by pesticides（9.2%）and alcohol（8.2%）.A significant increase in the trend of substance of poison was paraquat and party drugs.The most common exposure route of toxic agents was oral ingestion.Most suicide attempts were made by women（70.7%）.The higher frequency of poisoning events occurred in Aug and Sept.The mortality of the poisoning patients was 4.5%.The death events resulted from pesticide poisoning accounted for the first.Among them,110 cases died of paraquat poisoning,which accounted for 89.4% of all death patients.Conclusion：The common causes of poisonings were medicinal drugs,pesticides and alcohol.Party drugs poisoning has a significant increase trend.The patients of paraquat poisoning had a poor prognosis.The pathogenesis and clinical treatment of these poisons needed to be strengthened.Female suicide is still the main cause of acute poisoning,and young women should become the focus of social interventions to prevent poisoning.