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目的探讨小儿急性中毒在中毒原因、中毒途径、年龄构成等方面的特点及变化。方法回顾性分析重庆医科大学附属儿童医院2000—2011年1005例急性中毒患儿的住院资料,总结其临床特点。结果 1005例急性中毒患儿中,1～4岁患儿多见(50.02%)。药物中毒(26.07%)上升至首要中毒原因,以神经精神类药物(32.06%)为主,主要发生于≤3岁患儿(P<0.001),以及来自城镇患儿(P<0.001)。后依次为食物中毒(19.50%)、生物毒(16.92%)及农药中毒(14.73%)。农村患儿动物毒、农药及鼠药中毒明显多于城镇(P<0.001、P<0.001、P<0.05)。误服毒物(53.44%)为儿童急性中毒主要途径。自服毒物(48例)主要发生在>6岁患儿。急性中毒主要临床表现包括消化道症状(42.89%)、神经系统症状(31.74%)、呼吸道症状(11.14%)及肾功能衰竭(4.47%)。治疗有效443例(40.08%),好转519例(51.64%),未愈29例(2.89%),死亡14例(1.39%)。结论儿童急性中毒原因和途径因儿童年龄和家庭背景而异。儿童急性中毒临床表现多样,早期诊断治疗可提高治疗效果。
Objective To investigate the characteristics and changes of poisoning causes, poisoning pathways, age composition and other aspects of children acute poisoning. Methods The hospitalized data of 1005 children with acute poisoning from 2000 to 2011 in Children’s Hospital of Chongqing Medical University were retrospectively analyzed, and their clinical features were summarized. Results Among 1005 children with acute poisoning, 1 to 4 years old were more common (50.02%). Drug poisoning (26.07%) increased to the leading cause of poisoning, mainly neuropsychiatric drugs (32.06%), mainly in children ≤ 3 years (P <0.001), and from urban children (P <0.001). Followed by food poisoning (19.50%), biological toxicity (16.92%) and pesticide poisoning (14.73%). Animal poisoning, pesticide and rat poisoning in rural children were significantly more than those in urban areas (P <0.001, P <0.001, P <0.05). Misuse of poison (53.44%) is the main route of acute poisoning in children. Self-serving poison (48 cases) occurs mainly in children> 6 years of age. The main clinical manifestations of acute poisoning include gastrointestinal symptoms (42.89%), neurological symptoms (31.74%), respiratory symptoms (11.14%) and renal failure (4.47%). Treatment was effective in 443 cases (40.08%), improvement in 519 cases (51.64%), unhealed in 29 cases (2.89%) and death in 14 cases (1.39%). Conclusions The causes and ways of acute poisoning in children vary according to their age and family background. Children with acute clinical manifestations of acute and diverse, early diagnosis and treatment can improve the therapeutic effect.