沈阳地区某三甲医院6902例急性中毒患者流行病学分析

Epidemiological analysis of 6,902 patients with acute poisoning in a grade A tertiary hospital in Shenyang region

目的分析沈阳地区某三甲医院急诊科6902例急性中毒患者的临床和社会人口学模式,为本地区急性中毒的抢救和防治提供参考。方法对2012年1月1日-2018年12月31日期间该院所有急诊科就诊的中毒病例的人口统计数据进行统计分析,了解急性中毒流行病学特征。结果共发生6902名中毒患者就诊,占所有急诊病例的0.6%。其中,中毒死亡93例,病死率1.3%。男女比例为1∶1.14。患者的平均年龄为(36.2±15.1)岁。中毒发生率最高的年龄组为20~29岁(约占30.1%)。大多数的患者暴露类型被归为自杀性中毒(3835例,55.6%)。在自杀性中毒和滥用性中毒之间存在性别差异(χ^2=289.14,P<0.001):即女性比男性更容易发生自杀性中毒,而男性比女性更容易发生滥用性中毒。口服是最常见的中毒途径(86.1%)。最常见的四类有毒物质按组别依次为治疗性药物、农药、酒精以及气体;849例(12.3%)服用两种或两种以上的中毒物质。就具体物质而言,酒精、百草枯、一氧化碳和镇静催眠药是最常见的中毒物质。农药中毒发生率最高的季节为夏季而气体中毒最常见的季节为冬季。结论2012-2018年间,总体中毒人数呈下降趋势,本地区的急性中毒特征与十年前相比发生了变化。

Objective To analyze the clinical and social demography patterns of 6,902 acute poisoning patients admitted into the emergency department of a grade A tertiary hospital in Shenyang region so as to provide references for the management and prevention of acute poisoning in this region.Methods Demographic data regarding all poisoning cases admitted to the emergency department of the hospital from January 1,2012 to December 31,2018 were statistically analyzed,and the epidemiological features of acute poisoning were studied.Results A total of 6,902 poisoning patients were admitted to the hospital,accounting for 0.6%of the total emergency cases.There were 93 cases of poisoning death,and the case fatality rate was 1.3%.The sex ratio of male to female was 1∶1.14.The mean age of all patients was(36.2±15.1)years.The incidence rate of poisoning was found to be the highest in patients aged 20-29 years(about accounting for 30.1%).The majority of patients were classified as suicidal poisoning(n=3,835,55.6%).There was a significant gender difference in suicide and drug abuse(χ^2=289.14,P<0.001),females were involved in more suicidal poisonings than males,whereas males were more exposed to poisoning due to drug abuse.Oral administration was the most common route of poisoning(86.1%).The four most common toxic agent groups in decreasing order were therapeutic drugs,pesticides,alcohol and gases.849(12.3%)patients consumed two or more toxic agents.However,with regard to specific substances,alcohol,paraquat,carbon monoxide and sedatives/hypnotics were the four main toxic agents.The incidence rate of pesticide poisoning was found to be the highest in summer season,but the most common season for gas poisoning was winter.Conclusions The overall number of poisoning cases in 2012-2018 presented a downward trend.The characteristics of acute poisoning in this region were different from those of ten years ago.