586例急性中毒住院患儿临床特征分析

Clinical features of acute poisoning in hospitalized children: an analysis of 586 cases

摘要:

目的 对急性中毒住院患儿的临床特征进行分析，为儿童急性中毒的预防和治疗提供参考。方法 回顾性分析重庆医科大学附属儿童医院2006年1月至2015年12月出院并确诊为中毒的586例住院患儿的临床资料。结果 586例患儿中，男354例，女232例；年龄24 d至15.8岁；婴幼儿和学龄前期患儿450例（76.8%）；农村患儿463例（79.0%）；意外中毒551例（94.0%）。药物、农药、鼠药中毒分别221例（37.7%）、167例（28.5%）和175例（29.9%）。中毒物质在城市和农村患儿的分布差异有统计学意义（P < 0.01），其中城市中毒患儿以药物为主要中毒物质，农村患儿中农药中毒所占比例最高。药物、农药、鼠药中毒患儿的主要临床表现差异有统计学意义（P < 0.01），分别以神经系统、消化系统、循环系统症状为主；不同物质中毒患儿治疗总有效率差异无统计学意义。结论 儿童急性中毒主要发生在婴幼儿和学龄前儿童；多发生在农村；多为意外中毒；药物中毒是造成急性中毒的主要原因；不同物质所致中毒患儿主要的临床表现不同，但临床治疗的总有效率无明显差异。

Abstract:

Objective To investigate the clinical features of acute poisoning in hospitalized children. Methods A retrospective analysis was performed on the clinical data of 586 hospitalized children who were diagnosed with poisoning and discharged from the Children's Hospital of Chongqing Medical University between January 2006 and December 2015. Results The patients included 354 males and 232 females (age:24 days to 15.8 years). Of the 586 cases, 450 (76.8%) were infants and preschool children; 463 (79.0%) came from rural areas; 551 (94.0%) were hospitalized because of unintentional poisoning. The drug poisoning, pesticide poisoning, and rodenticide poisoning accounted for 221 cases (37.7%), 167 cases (28.5%), and 175 cases (29.9%) respectively. There was a significant difference in the distribution of the poisoning toxins between urban and rural children (P < 0.01), and drugs and pesticides were the most common toxins for urban and rural children respectively. There were significant differences in main clinical manifestations between the children with drug poisoning, pesticide poisoning, and rodenticide poisoning (P < 0.01), who presented with main clinical symptoms of the nervous system, digestive system, and circulatory system respectively. There was no significant difference in overall response rate between the children poisoned by different toxins. Conclusions Acute poisoning is most common in infants and preschool children. The majority of the patients are from rural areas. The majority of acute poisoning is unintentional. Poisoning by drugs is the main type of acute poisoning. There is no significant difference in overall response rate between the children poisoned by different toxins, but their clinical manifestations are different.