285例急性中毒患儿相关因素分析

目的：回顾性分析西安市儿童医院重症医学科（ PICU）2010年8月至2014年8月收治的285例急性中毒病例资料，总结儿童急性中毒的相关因素及治疗情况。方法对285例急性中毒病例按中毒发生的年龄、性别、原因、分类、治疗等不同情况进行分析讨论，并预见积极有效的预防措施、评估血液净化的治疗效果。结果①285例中毒患儿中意外中毒234例，以1～3岁为中毒的主要年龄段（47．7％），且男童发生率高。6、7、8月份为发病高峰。中毒主要发生在家中（93．3％），其中农村（85．9％）发生率较城市高。中毒的原因主要是以误服为主，其中农村以非药物中毒为主（77．1％），城市以药物中毒为主（70％）；②中毒后主要表现为神经系统及消化系统症状，易合并多脏器功能障碍；③血液净化治疗的抢救成功率97．9％。结论中毒的预防和急救是关键，应加强药品市场管理，家庭对农药与药物的监管和宣教，重视儿童的心理变化，避免有意识行为所致的中毒。血液净化治疗在急性中毒治疗中是重要的手段，有良好的效果。

Relevant factors of 285 children with acute poisoning

Objective To retrospectively analyze the clinical data of 285 children patients with acute poisoning admitted in PICU of Xi ’ an Children’s Hospital from August 2010 to August 2014 and to summarize the relevant factors and treatments .Methods The cases were discussed in terms of age, gender, cause, classification and treatment, and therapeutic efficacy of preventive measures and blood purification were evaluated .Results There were 234 cases of accidental poisoning , and the major age period of poisoning was 1-3 year old (47.7%).It was more frequently found in boys .Poisoning peak was at June, July and August.Most poisoning happened at home (93.3%), and the incidence was higher in rural areas (85.9%) than in urban areas.The leading cause of poisoning was accidental administration.The non-drug poisoning mostly happened in rural areas (77.1%) and drug toxicity most occurred in urban areas (70%). Poisoning primarily affected nervous and digestive system , and might cause multiple organ dysfunction syndrome easily .Rescue success rate of blood purification was 97.9%.Conclusion Precaution and first-aid for poisoning play the key roles for curing patients .The supervision of medical market and the education on pesticide and medicine for family should be enhanced .Attention should be paid on psychological changes of children to avoid deliberate poisoning .The blood purification is the most important and effective treatment to cure acute poisoning .