以呼吸抑制为主要表现的小儿药物中毒16例分析

目的对表现为呼吸抑制的小儿药物中毒病例进行总结,以指导临床。方法分析16例表现为呼吸抑制的小儿药物中毒的临床资料。结果16例药物中毒患儿中滴鼻净中毒4例,复方地芬诺脂中毒8例,氨酚黄那敏颗粒中毒4例,均为医源性;口服中毒12例,外用中毒4例。给予吸氧、洗胃及纳络酮治疗后,愈后良好。结论阿片类药物中毒的特效解毒剂为纳络酮,及时、小剂量维持及早期低流量吸氧是提高治愈率的关键,应严格掌握小儿用药的剂量、适应证,了解药物不良反应。     

小儿误服咳必清中毒13例分析

目的分析小儿误服咳必清中毒的临床表现,以早期诊断。方法回顾性分析13例误服咳必清中毒患儿的临床资料和实验室检查,总结其发病规律。结果症状出现频率最高为阿托品中毒样反应13例,其次为锥体外系反应3例;心肌酶谱CK及CK-MB增高11例,心电图ST-T改变5例,肝功损害2例。结论咳必清中毒患儿应常规检查心肌酶谱、心电图、肝功,重者注意检查脑电图。     

中毒

901226 48例小儿急性中毒的病因分析/杨晓松…∥中国农村医学。-1990,(1)。-23～24 男26例,女22例,年龄1.5月～14岁。2例抢救无效死亡。中毒的原因有:①幼稚无知:16例6岁前的小儿及12例蕈中毒的小儿,食入毒蕈或药物时并不知会引起中毒;②偶然因素:把敌敌畏当止咳糖浆服,把汽油当菠萝汽酒喝等,③服毒寻短,多于见7～14岁患儿,32例中有9例,因做错事或其它原因受家长斥责服毒寻短。中毒途径为消化道45例,皮肤2例,呼吸道1例。中毒原因以蕈中毒(12例)     

小儿复方地芬诺酯中毒32例临床分析

目的:分析小儿复方地芬诺酯中毒的救治与预防。方法:回顾性分析我院2000年2月至2010年12月收治入院的32例复方地芬诺酯中毒患儿的临床资料。结果:除1例超量误服患儿死亡外,其他患儿均抢救成功,纳洛酮治疗的疗效满意。结论:早期发现、早期诊断并及时应用纳洛酮是抢救复方地芬诺酯中毒成功的关键。     

复方苯乙哌啶中毒46例临床分析

目的:对复方苯乙哌啶中毒病例进行临床分析。方法:对46例复方苯乙哌啶中毒病例的临床治疗资料进行回顾性研究。结果:年龄1～2岁18例,2～4岁28例。除5例为医源性外,其余均为误服。给予洗胃纳洛酮治疗后,绝大部分预后良好。结论:阿片类药物中毒的特效解毒剂为纳洛酮,及时、足量、足疗程地应用是提高治愈率的关键。患儿服用药物一定要遵医嘱,家长要加强防范意识。     

小儿万灵急性中毒11例回顾性分析

目的总结小儿万灵中毒的临床特点及治疗经验。方法回顾性分析11例万灵中毒患儿临床表现及诊治经过。结果 11例患儿均出现毒蕈碱样症状及中枢神经系统功能失调症状,9例出现烟碱样症状。血胆碱酯酶活力均下降。所有患儿均予洗胃、导泻、利尿、补液及应用阿托品治疗,对胆碱酯酶活力〈30%者给予氯解磷定治疗,11例患儿均治愈出院。结论小儿万灵中毒与有机磷中毒症状类似,均有毒蕈碱样症状及中枢神经系统功能失调症状,治疗关键是及早洗胃,及早应用阿托品。     

小儿复方地芬诺酯中毒32例临床分析

目的 分析小儿复方地芬诺酯中毒的救治与预防。方法对32例复方地芬诺酯中毒患儿的临床表现、诊断、实验室检查、治疗过程进行回顾性分析。结果除1例超量误服患儿死亡外。其他患儿均抢救成功，纳洛酮治疗的疗效满意。结论早期发现、早期诊断并及时应用纳洛酮是抢救复方地芬诺酯中毒成功的关键。     

197例儿童中毒原因及临床特征分析

摘要：目的　总结儿童中毒的危险因素及临床特点。 方法　对1991年1月至2007年12月山西省昔阳县人民医院儿科住院诊治的197例中毒儿童进行回顾性分析。 结果　儿童中毒原因以药物中毒为主,常为误服药物,多见于1～3岁;＞12岁中毒者多为自行服毒。神经系统、消化系统及心血管系统受累率分别为75.6%（149例）、39.1%（77例）及25.9%（51例）。 结论　1～3岁为儿童中毒的高发年龄,误服药物为中毒的主要原因;中毒易累及神经、消化及心血管系统。儿童中毒的危险因素呈多样性,认识上述危险因素,对预防儿童中毒有重要意义。     

纳洛酮救治小儿氯氮平中毒1例

小儿急性中毒高发年龄为1~6岁,多属意外误服。随着社会经济发展和竞争加剧,精神病患者逐年上升,儿童精神类药物中毒增加了11%[1]。氯氮平是广谱抗精神病药,具有较强的抗精神病和快速嗜睡作用，很少产生锥体外系不良反应；16岁以下儿童不宜服用。具有强大的镇静、催眠作用，也具有毒蕈碱样作用；而常见副反应有昏迷、急性肺水肿、发热、低血钾、肝功能损害、造血系统损害等。笔者用纳洛酮成功救治1例氯氮平中毒患儿，现报道如下。     

急性中毒108例流行病学调查及分析

目的：通过分析急性中毒流行病学资料,为今后急性中毒防治提供参考依据。方法：回顾性分析我院急救中心108例中毒患者诊治资料,对患者中毒的类型、性别、年龄、意图、中毒后在院前有无给予初级处理等加以分析。结果：108例急性中毒病例中主要是一氧化碳中毒53例,药物中毒34例,酒精中毒9例,食物中毒8例,化学制剂中毒4例;自杀人群中女性明显高于男性（1：0．2）,在女性服毒自杀中回族20例,汉族6例,维吾尔族2例,哈萨克族1例;在院前是否给予初级处理中,没有给予处理的61例,一氧化碳中毒占到7例,其他中毒的占到54例。结论：一氧化碳中毒最多,女性服毒自杀比例最高,高发的年龄段为20～39岁,而又以回族女性居多,中毒后在来院前没有给予初级处理的居多。     

癫痫缓解期患儿减停药后复发的相关因素分析

目的 探究分析癫痫缓解期患儿减停药后2年内病情复发情况,并对诱导复发的相关因素进行分析.方法 随访2016年3月至2018年3月在本院经抗药物治疗后处于癫痫缓解期的患儿168例.回顾性分析患儿的临床资料,分析引起癫痫复发的相关因素.结果 随访2年,168例患儿中40例复发,复发率为23.81％.年龄<6岁、治疗前病程≥...     

儿童过敏性紫癜临床症状与紫癜性肾炎的相关性研究

目的探讨儿童过敏性紫癜临床症状与紫癜性肾炎的相关性。方法 2013年5月至2015年4月深圳市宝安区妇幼保健院儿科收治住院的过敏性紫癜患儿200例,根据是否并发肾炎分为肾炎组109例和非肾炎组91例。对两组患儿的年龄及临床症状(皮疹反复发作时间、消化道出血、腹痛、关节痛、血管水肿性水肿)进行单因素及Logistics多因素分析。结果单因素分析结果显示,儿童过敏性紫癜肾炎与年龄、皮疹反复发作时间、消化道出血、腹痛、关节痛明显相关(P0.01);经Logistics非条件多因素分析结果显示,年龄≥8岁、皮疹反复发作时间≥4周、消化道出血、腹痛、关节痛是引发儿童过敏性紫癜肾炎的独立危险因素(P0.01)。结论儿童过敏性紫癜肾炎的产生与临床症状密切相关,其中年龄≥8岁、皮疹反复发作时间≥4周、消化道出血、腹痛、关节痛是引发紫癜性肾炎的独立危险因素。     

子痫前期头颅磁共振异常高危因素分析

目的:探讨子痫前期头颅磁共振异常的高危因素.方法:回顾分析2017年1月至2019年12月在南京大学医学院附属鼓楼医院妇产科分娩的子痫前期及慢性高血压并发子痫前期并接受头颅磁共振检查者,根据影像学检查结果,分为磁共振异常组和正常组.比较两组孕妇的一般临床资料、入院后血压评估、实验室检查结果,通过二元logis-tic回...     

儿童过敏性紫癜临床疗效分析及随访

目的对155例儿童过敏性紫癜的临床疗效及随访结果进行分析,探讨中医药对该病的治疗。方法对2013年4月至2014年3月河南中医药大学第一附属医院儿科收治的155例HSP患儿临床数据进行分析。结果本组患儿男女比例为1.5∶1,以学龄儿童为主;多发于冬春季节;发病诱因以上呼吸道感染为主。均有典型皮肤紫癜,其中伴关节肌肉肿痛54.2%,伴消化道症状46.5%,伴肾损伤6.5%,伴肾炎13.5%。痊愈136例(87.7%),显效13例(8.3%),有效6例(3.9%),无效0例;随访6个月,复发率7.1%。结论中医药治疗小儿过敏性紫癜临床疗效肯定,值得临床推广应用。     

Are obstetric risk factors and bowel symptoms associated with defaecographic and manometric abnormalities in women awaiting hysterectomy?

Abdominal hysterectomy has been shown to affect anorectal function. These studies are either population-based or have been performed retrospectively. It is not clear from the literature whether those subjects awaiting hysterectomy already have an element of pelvic floor failure and which may be related to obstetric risk factors. A complete anorectal assessment was performed in a group of women awaiting hysterectomy who did not volunteer any bowel symptoms. The patients studied were part of an ongoing study of the functional effects of abdominal hysterectomy. All had their anorectal function assessed before their respective surgery by a questionnaire (functional bowel score), Cleveland continence score, endoanal ultrasound (U/S), anal manometry, defaecatory proctogram and colonic transit. A detailed obstetric history, which included risk factors such as parity, type of delivery, duration of labour and elevated birth weight, were also recorded. Patients with previous bowel disease, bowel surgery and anal sphincter repair were excluded. There were 39 subjects with a median age of 43 years (range 31-65), respectively. Thirty-three rectocoeles and 22 intussusceptions were demonstrated. Two had poor puborectalis function, while five had cough incontinence. Two women had abnormal colonic transit. Thirteen had abnormal anal manometry. Endoanal ultrasound was normal in all patients. None of the obstetric risk factors were associated with rectocoele, intussusception or abnormal anal manometry. Low squeeze pressure was associated significantly with more bowel symptoms (P=0.03). However, rectocoele, intussusception, abnormal colonic transit, abnormal resting anal pressure and maximal tolerated volume were not statistically significantly associated with bowel symptoms. The majority of female subjects who were awaiting hysterectomy had physiological and proctographic abnormalities consistent with pelvic floor failure. Obstetric risk factors were not associated with rectocoele, intussusception, abnormal colonic transit and anal manometry in this cohort of patients. Similarly, the majority of proctographic abnormalities were not associated with bowel symptoms. However, a trend was noted associating bowel symptoms with manometric abnormalities.     

Risk factors associated with blood transfusion in ectopic pregnancy.

OBJECTIVE: To determine the risk factors associated with blood transfusion in ectopic pregnancy. STUDY DESIGN: A retrospective chart review of the presentation and hospital course of ectopic pregnancies managed over five years at two hospitals was undertaken. Thirty-two variables, including demographics, presenting signs and symptoms, and intraoperative findings, were examined with univariate and multivariate logistic modeling. RESULTS: Among 185 patients with histologically confirmed ectopics who were managed surgically, 8.6% (16 women) required transfusion. Multivariate analysis of risk factors for blood transfusion demonstrated a statistically significant association with (1) initial hemoglobin < 10 g/dL (odds ratio [OR] 38.8, 95% confidence interval [CI] 6.0-356.8); (2) human chorionic gonadotropin levels > or = 6,500 mIU (OR 18.1, 95% CI 3.6-158.1); and (3) abnormal bleeding on presentation (OR 0.08, 95% CI 0.007-0.42). The presence of two of these factors had a sensitivity of 82% (95% CI 48-98%) and a positive predictive value of 33% (95% CI 16-54%). No case had all three factors. CONCLUSION: This study was, to our knowledge, the first regression analysis of risk factors for transfusion associated with ectopic pregnancy. It demonstrated that initial hemoglobin and human chorionic gonadotropin levels as well as abnormal bleeding on presentation are independent risk factors for blood transfusion in ectopic pregnancy.     

血液灌流治疗急性药、食物中毒的经验分析

目的:通过2005年～2008年我院急性药、食物中毒59例病人,其中血液灌流治疗32例的回顾分析,探讨血液灌流(HP)对抢救急性药、食物中毒的效果,特别是HP在抢救有机磷中毒中应该注意的事项。方法:本文采用回顾性研究,以急性药、食物中毒59例病人为资料,分为有机磷中毒HP治疗27例,有机磷中毒非HP治疗8例和其他药、食物中毒HP治疗24例三组资料进行对比,三组病人入院后均首先常规给予洗胃、补液支持、有机磷中毒静推阿托品、胆碱酯酶复能剂、其他中毒使用相应解毒剂等综合治疗,在此基础上,应用血液灌流。结果:有机磷中毒HP治疗组抢救成功率为96.3%,有机磷中毒非HP治疗组抢救成功率为37.5%,其他药、食物中毒HP治疗组抢救成功率为100%。结论:HP治疗急性药、食物中毒效果是确切的,但有机磷中毒抢救最重要的是使用阿托品和胆碱酯酶复活剂恢复胆碱酯酶活性,解除中毒症状。因此有机磷中毒HP治疗时必须同时进行常规的阿托品和胆碱酯酶复活剂等治疗。     

An analysis of risk factors associated with blood transfusion in ectopic pregnancy

Objective: To determine the risk factors associated with blood transfusion in ectopic pregnancy.Methods: A retrospective chart review of the presentation and hospital course of ectopic pregnancies managed over 5 years at two hospitals was undertaken. Thirty-two variables, including demographics, presenting signs and symptoms, and intraoperative findings, were examined in univariate and multivariate logistic modeling.Results: Among 185 patients with histologically confirmed ectopic pregnancies who were managed surgically, 8.6% or 16 women required transfusion. Multivariate analysis of risk factors for blood transfusion demonstrated a statistically significant association with 1) initial hemoglobin <10 g/dL (odds ratio [OR] 38.8, 95% confidence interval [CI] 6.0–356.8) and 2) hCG levels ≥ 6500 mIU (OR 18.1, 95% CI 3.6–158.1), as well as 3) abnormal bleeding on presentation (OR 0.08, 95% CI 0.007–0.42. Presence of two of these factors has a sensitivity of 82% (95% CI 48–98%) and a positive predictive value of 33% (95% CI 16–54%). No case had all three factors present.Conclusion: This report is, to our knowledge, the first regression analysis of risk factors for transfusion associated with ectopic pregnancy. It demonstrates that initial hemoglobin and hCG levels as well as abnormal bleeding on presentation are independent risk factors for blood transfusion in ectopic pregnancy.     

儿童意外伤害的危险因素分析

目的 分析儿童意外伤害的临床特点及危险因素,探讨针对性的预防措施,降低意外伤害发生率.方法 选取我院急诊科2015年1月至2019年12月五年期间接诊的意外伤害患儿1002例为研究对象,对患儿的临床资料进行回顾性分析,并随机抽取同期接诊的急症患儿1002例为对照组.结果 五年期间急诊科接诊的意外伤害患儿1002例,占同...     

Plasma vitamin A in mothers of children with orofacial clefts

OBJECTIVES: The contribution and exact role of exogenous factors, such as medications and drugs during pregnancy, maternal nutrition, in the etiology of orofacial clefts is not established. Vitamin A is essential for embryogenesis, both the lack and excess of retinol result in congenital malformations. DESIGN: This study was aimed to establish vitamin A status in Polish mothers of children with isolated orofacial clefts. MATERIAL AND METHODS: 34 mothers of children with isolated cleft lip (CL), 83 mothers of children with cleft lip and palate (CLP), 42 mothers of children with isolated cleft palate (CP) were studied. The control group consisted of 67 women who gave birth to healthy children. All participants were healthy women without symptoms of malabsorption. Plasma retinol levels were determined by high-performance liquid chromatography. RESULTS: There were no differences in mean plasma vitamin A levels between CL--2.09 +/- 0.61 mumol/l, CLP--2.21 +/- 0.52 mumol/l, CP--2.15 +/- 0.62 mumol/l and control--2.08 +/- 0.52 mumol/l. None of participants had vitamin A deficiency (concentration of retinol < 0.8 mumol/l). Among women, who were not supplemented with retinol containing vitamins during 3 months prior the study, 10.6% of mothers of children with orofacial clefts (n = 132) and only 5.8% of controls (n = 52) had levels of retinol above upper norm for women of childbearing age (N < 2.8 mumol/l). CONCLUSION: Periconceptional multivitamin supplementation has been reported to decrease the risk of orofacial clefts in offspring, but high intake of preformed vitamin A (retinol) might be undesirable.