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目的:了解广州地区医院急诊科对急性中毒患者进行的救护措施,为今后规范急性中毒的救护及培训提供参考依据。方法:于2013年在全市范围随机选取36家各级别的医院急诊科为调查点,分析对急性中毒患者进行洗胃、口服催吐、活性炭吸附、导泻等各项救护措施的具体情况。结果:37.5%的三级医院和35.0%的二级及以下级别医院能根据毒物性质选择合适的洗胃液,50.0%的三级医院和40.0%的二级及以下级别医院对急性口服药物中毒患者进行药物导泻;与二级及以下级别医院相比,三级医院对急性中毒患者洗胃液的选择及导泻方法无明显差异,但在活性炭的使用及紧急床边血液净化疗法有统计学差异(P<0.05)。结论:加强急性中毒救护措施的培训,规范各级医院对急性中毒的救治,鼓励没有开展血液净化治疗的二级及以下级别医院急诊科及时将急性危重中毒患者向上级医院转送,保证患者能够得到有效的综合救治。
OBJECTIVE: To understand the ambulance measures taken by emergency department of Guangzhou hospital for patients with acute poisoning and to provide reference for the future standardization of ambulance and training of acute poisoning. Methods: In 2013, 36 emergency department of hospitals at all levels were randomly selected as the investigation points to analyze the specific conditions of ambulances such as gastric lavage, oral vomiting, activated carbon adsorption and catharsis in acute poisoning patients. Results: 37.5% of tertiary hospitals and 35.0% of secondary and lower level hospitals could choose appropriate gastric lavage according to the nature of poison, 50.0% of tertiary hospitals and 40.0% of secondary hospitals and lower levels of acute oral drug poisoning patients For drug catharsis; compared with the second-level and lower-level hospitals, tertiary hospital for acute poisoning patients with gastric lavage fluid selection and cataplasm methods no significant difference, but the use of activated carbon and emergency bedside blood purification therapy were statistically different (P <0.05). Conclusion: To strengthen the training of acute poisoning and ambulance measures, to standardize the treatment of acute poisoning in hospitals at all levels, and to encourage the emergency department of second-grade and below hospitals that do not carry out blood purification treatment to promptly transfer the patients with acute critically poisoned poisonings to the higher-level hospitals so as to ensure that patients can get Effective comprehensive treatment.