区域间急性有机磷杀虫剂中毒诊疗行为差异分析

Analysis on behavior differences during diagnosis and treatment of acute organophosphorus pesticide poisoning among different regions

目的了解不同区域急性有机磷杀虫剂中毒诊疗行为的差异。方法选择河北、黑龙江、重庆区域共18家县级医院2012年急性有机磷杀虫剂中毒住院病例进行回顾性调查,比较胆碱酯酶活性检测、阿托品及复能剂使用情况、住院天数、费用及预后。结果住院天数中位数4 d,总费用2 755.39元,药品费用1 185.00元。三区域间胆碱酯酶活性检测次数、阿托品的使用天数和剂量、住院总费用的差异均有统计学意义,中重度病例的复能剂使用天数差异有统计学意义。结论目前不同地区急性有机磷杀虫剂中毒诊疗行为仍存在一定差异,制定其临床路径非常必要且紧迫。

Objective To investigate the differences in diagnosis and treatment of acute organophosphorus pesticide poisoning among different regions of China. Methods All the acute organophosphorus poisoning patients admitted to 18 county hospitals in Hebei or Heilongjiang Provinces and Chongqing City, respectively, during 2012 were retrospectively studied. The main treatments, average hospitalization days, hospital costs and prognosis were collected and analyzed. Results Cholinesterase ac- tivity monitoring number, dose and duration of atropine, total hospital costs showed statistical significance among three regions; additionally, the medication days of cholinesterase reactivator in moderate and severe patients also had statistical significance among three regions. Conclusion The results suggested that there were still some differences in diagnosis and treatment behavior among different areas, therefore, it should be necessary and urgent to develop a normative clinical pathways for acute organophosphate pesticide poisoning.