误服拟除虫菊脂类蚊香液47例临床诊治分析

Analysis of clinical diagnosis and treatment of 47 cases of misadministered mosquito-repellent liquid of Lipopolipids

目的探讨儿童误服拟除虫菊脂类蚊香液的临床特点及诊治过程。方法回顾性分析河南省儿童医院2017年4月至2022年4月收治的52例误服电蚊香液患儿的临床资料。根据“急性中毒诊断与治疗中国专家共识”将就诊患儿临床表现分为无症状中毒、轻度中毒、中度中毒及重度中毒。计量资料比较采用独立样本t检验,计数资料比较采用χ^(2)检验或校正χ^(2)检验或Fisher精确概率法。结果根据纳入、排除标准筛选后共纳入47例患儿,男27例(57.4%),女20例(42.6%),年龄(2.4±1.2)岁,农村21例(44.7%),城市26例(55.3%);其中无症状中毒患儿24例(51.1%),轻度中毒21例(44.7%),中度中毒0例,重度中毒2例(4.2%),无死亡病例。误服电蚊香液中毒患儿数量2018年最多,2018年后逐年下降;误服时间呈明显的季节性分布,所有就诊患儿就诊月份为每年的4到10月份,6月份最多。将24例无症状中毒患儿纳入无症状组,21例轻度中毒及2例重度中毒患儿纳入有症状组,临床资料分析显示,两组患儿均无后遗症;与无症状组相比,有症状组患儿自服药至来院时间、留院时间更长,白细胞增高、呕吐及皮肤黏膜感觉异常比例更高,差异均具有统计学意义(P<0.05)。结论误服电蚊香液患儿以婴幼儿为主,临床症状轻,预后较好,入院时有抽搐、意识障碍,白细胞、肌酸激酶同工酶更高,患儿病情更重,临床需早期识别重症患儿。

Objective:To investigate the clinical characteristics,diagnosis and treatment process of children mistakenly taking mosquito-repellent incense solution.Methods:The clinical data of 52 children admitted to Henan Children's Hospital,Children's Hospital Affiliated to Zhengzhou University from April 2017 to April 2022 were retrospectively analyzed.According to the Chinese expert consensus on diagnosis and treatment of acute poisoning,the clinical manifestations of the children were divided into asymptomatic poisoning,mild poisoning,moderate poisoning and severe poisoning.The independent sample ttest,and the counting data adopts χ^(2) inspection or correction χ^(2) test or Fisher exact probability method were adopted for the measurement data.Results:According to the inclusion and exclusion criteria,a total of 47 children were included,including 27 males(57.4%),20 females(42.6%),aged(2.4±1.2)years,21 rural(44.7%)and 26 urban(55.3%);among them,there were 24 cases of asymptomatic poisoning(51.1%),21 cases of mild poisoning(44.7%),0 case of moderate poisoning,2 cases of severe poisoning(4.2%),and no deaths.The number of children poisoned by electric mosquito repellent liquid was the highest in 2018,and has decreased year by year since 2018;the time of accidental ingestion showed an obvious seasonal distribution.The months of treatment for all children were from April to October every year,and June was the most.24 children with asymptomatic poisoning were included in the asymptomatic group,21 children with mild poisoning and 2 children with severe poisoning were included in the symptomatic group;clinical data analysis showed that there were no sequelae in both groups;compared with the asymptomatic group,the children in the symptomatic group had a longer time from taking medicine to coming to the hospital and staying in the hospital,and a higher proportion of leukocytosis,vomiting and abnormal skin and mucous membrane sensation(P<0.05).Conclusion:The children who accidentally took electric mosquito coil liquid are mainly infants and young children,with mild clinical symptoms and good prognosis.The children with convulsions,disturbance of consciousness,higher leukocyte and creatine kinase isoenzyme at admission are more seriously ill.Early identification of severe children is necessary.