广西急性中毒防控救援管理方法探讨

Exploration on the prevention-control and rescue management of acute poisoning in Guangxi

目的探讨广西急性中毒防控救援管理的方式。方法以广西63家市、县、乡医疗单位2005-2009年期间收治的6 011例中毒病例为调查对象,从中毒发病、发病速度、城乡发病、农村救治条件、中毒现场处置、市县乡中毒救治方法、造成的经济损失等方面进行分析,提出针对性管理措施。结果广西急性中毒平均每年发病数达12 185.12例,以12.14%的速度在递增;其中农村发病数(占63.08%)是城镇(36.92%)的1.71倍;农村中毒死亡率(3.37%)是城镇(1.21%)的2.79倍;估计其造成的经济损失,仅医疗费一项已超2亿元。各地应对急性中毒防控救援不力,并缺乏有效管理;各地乡镇开展中毒救治仅占调查总数的25.49%(13/51);对中毒病例的现场处置率仅占总病例数的17.39%(1 041/5 986);市、县、乡救治中毒方法主要以"清除体内毒物(55.93%)、解毒药治疗(56.10%)、对症处理(51.66%)"为主,对新方法"血液净化处理(仅占6.12%)"的应用很少。结论针对广西现状,应通过建立机构管理、信息管理和措施管理,促进改变广西急性中毒防控救援现状。

Objective To explore the prevention-control and rescue management of acute poisoning in Guangxi. Methods A total of 6 011 cases of poisoning from 63 medical units in Guangxi during 2005-2009 were investigated and analyzed for disease onset, the onset speed, the onset of urban and rural areas, the rural treatment condition,the disposal of poisoning scene, the treatment methods of city, county, villages and towns, and the economic losses. The specific management measures were put forward. Results An average of 12 185.12 cases of poisoning were reported annually in Guangxi, increasing at a rate of 12.14%. The rural incidence(63.08%) was 1.71 times that of urban areas(36.92%), and the rural death rate(3.37%) was 2.79 times that of urban areas(1.21%). The economic losses were estimated to be more than 200 million yuan for only medical cost. The dealing with acute poisoning was found to be poor,and effective management measures were lacked. Only 25.49%(13/51) villages and towns had developed poisoning treatment, and the site-disposal rates accounted only for 17.39%(1 041/5 986) of the total cases. The local treatment methods were mainly giving priority to removing in-vivo toxins(55.93%), applying antidotes(56.10%), taking symptomatic treatment(51.66%), and the new method of blood purification(6.12%) was rarely used. Conclusion To improve the current situation of prevention-control and rescue management of acute poisoning in Guangxi, the organizational management, information management and measure management should be strengthened.