481例儿童急性中毒临床分析

A clinical analysis of acute poisoning in 481 children

目的分析近10年儿童急性中毒的临床特点,为儿童急性中毒的预防提供参考信息。方法回顾性分析2010年1月至2019年12月张家界市人民医院儿科收治的481例0~14岁儿童急性中毒病例的临床资料。分析患儿性别、年龄分布、发生时间、季节分布、中毒途径、中毒原因及毒物类型,比较2010至2014年与2015至2019年前后5年儿童急性中毒情况。结果481例患儿中男284例(59.0%),女197例(41.0%),以幼儿期(38.9%)与学龄前期(32.2%)为主。中毒原因前3位分别为:误服/误食321例(66.7%)、吸入或接触89例(18.5%)、食物中毒30例(6.2%);毒物类型前3位分别为:农药146例(30.4%)、常用药物113例(23.5%)、一氧化碳80例(16.6%)。不同年龄、发生时间及发生季节中毒原因及毒物类型比较差异有统计学意义(P<0.05)。前5年与后5年对比分析:儿童急性中毒病例略有下降,男童及幼儿期病例数呈增长趋势;不同发生时间段及中毒原因比较差异无统计学意义;季节分布变化差异有统计学意义(P<0.05),前5年多发于夏季、冬季,后5年以春季、秋季多发;毒物类型分布变化比较差异有统计学意义(P<0.05),农药、常用药物等5类呈增长趋势,一氧化碳等3类呈下降趋势。结论不同年份儿童急性中毒临床特征存在一定差异,应采取针对性的预防措施,减少中毒意外伤害的发生。

Objective To analyze the clinical characteristics of acute poisoning in children in recent 10 years,and to provide reference information for the prevention of acute poisoning in children.Methods The clinical data of 481 children aged 0-14 years with acute poisoning admitted to the department of Pediatrics,Zhangjiajie People's Hospital from January 2010 to December 2019 were retrospectively analyzed.The gender,age distribution,time of occurrence,seasonal distribution,route of poisoning,cause of poisoning and type of poison were analyzed,the acute poisoning of children in 2010-2014 and 2015-2019 were compared.Results Among the 481 children,284 cases(59.0%)were male and 197 cases(41.0%)were female,mainly in early childhood(38.9%)and preschool(32.2%).The top three causes of poisoning were:321 cases(66.7%)of mistakenly taking/eating,89 cases(18.5%)of inhalation or contact,and 30 cases(6.2%)of food poisoning;the top three types of poisons were:146 cases(30.4%)of pesticides,113 cases(23.5%)of commonly used drugs,and 80 cases(16.6%)of carbon monoxide.There were significant differences in the causes and types of poisoning among different ages,occurrence time and seasons(P<0.05).Comparative analysis of the first five years and the last five years:the number of acute poisoning cases in children decreased slightly,and the number of cases in boys and early childhood cases showed an increasing trend;there was no significant difference in different time periods and causes of poisoning,the difference in seasonal distribution was statistically significant(P<0.05),in the first 5 years,it was more common in summer and winter,and in the latter 5 years,it was more common in spring and autumn;there was statistically significant difference in the distribution of toxicant types(P<0.05),pesticides,commonly used drugs and other five categories showed an increasing trend,while carbon monoxide and other three categories showed a decreasing trend.Conclusion There are some differences in the clinical characteristics of acute poisoning in children in different years,targeted preventive measures should be taken to reduce the occurrence of accidental poisoning injuries.