磷化铝灭鼠安全应用的研究

目的探讨磷化铝作为一种灭鼠剂进行鼠洞灭鼠的安全性。方法在社区采用磷化铝堵洞灭鼠,收集近几年磷化铝的使用量和驻市医院化学性食物中毒的病例报告,比较、分析南宁市磷化铝的使用量和化学性食物中毒的发生情况。结果 2003-2007年间发生的39起化学性食物中毒,无一例与磷化铝有关。结论社区使用磷化铝灭鼠是安全的。     

PROGNOSTIC FACTORS IN ALUMINIUM PHOSPHIDE POISONING

A prospective study was done on 12 consecutive cases of aluminium phosphide poisoning admitted to a zonal hospital in Punjab. Patients were in 18-36 years age group and mortality was more in females. The dose of aluminium phosphide was more in non-survivors and fresh tablets were more likely to cause fatality. Early vomitting and prompt initiation of treatment resulted in better outcome. Survivors responded to treatment early, but duration of shock had no predictive value. Shock and cardiac arrhythmias were present in all cases and extracardiac complications occurred more commonly in fatal group. With vigorous treatment of shock and other complications 33 per cent of the cases could be saved.KEYWORDS: Aluminium phosphide poisoning, Complications, Mortality, Prognostic factors     

Study of victims of organophosphorus compound poisoning: evaluation after medicolegal autopsy

Indiscriminate use of organophosphorus compounds (OPC) increases the potential threat of self-poisoning and death. To make a conclusive diagnosis on academic interest a retrospective record-based study was undertaken. Postautopsy studies were carried out on 100 victims of OPC poisoning by collecting data from following 3 sources: Medicolegal autopsy reports, inquest reports, and inpatient case sheets. Mode of ingestion of OPC was to commit suicide. Incidence was more in 20 to 30 years age group, in females and in urban area. Diagnosis was confirmed by history of poison exposure, clinically well-defined cholinergic effects, and characteristic autopsy findings. Early and correct identification of the cause of poisoning enables specific treatment. Restrictions on access of very toxic pesticides through national policies and enforcement, public education on storage and safe use, early recognition of poisoning, and appropriate medical management may reduce the incidence of poisoning and death.     

Aluminium phosphide poisoning: a prospective study of 16 cases in one year

Sixteen patients suffering from aluminium phosphide poisoning were treated during the year from January 1985 to December 1985. These accounted for approximately half the total number of cases of acute poisoning. Profuse vomiting, pain in the upper abdomen and shock were the most common presenting features. Six patients succumbed to their illness. Analysis of various prognostic factors revealed that ingestion of 'unexposed' tablets of aluminium phosphide taken from a freshly opened bottle was associated with a greater risk of fatal outcome. Aluminium phosphide poisoning has become an important matter of public health in parts of India.     

自杀性急性中毒患者的临床分析

目的通过对自杀患者急性中毒资料进行分析,为今后自杀患者发生急性中毒提供防治参考依据。方法对2005年1月至2009年6月我院收治的932例自杀急性中毒患者的中毒情况、月份分布、患者性别与年龄进行分析研究。结果自杀性急性中毒病例中,女性551例,男性381例。自杀性中毒年龄发生在19-38岁者占60．08％。自杀性急性中毒的人数与国民经济发展呈负相关（r=-0．985,P〈0．05）。自杀急性中毒时间以每年1,2,5,6月多见。结论自杀性急性中毒患者以中青年为主,且女性多见;冬季和夏季自杀性急性中毒病例居多;经济发展速度快,则自杀性中毒人数相对较低。     

589例有机磷农药中毒的相关因素分析

为探讨有机磷农药中毒（ＯＰＰ）各相关因素的分布特点及预防措施,对５８９例ＯＰＰ的各相关因素进行回顾性分析。发现ＯＰＰ患者中,非生产性中毒比例高,以女性居多,且多以家庭矛盾为诱因而服毒自杀;２０～３９岁年龄组发病率高;以４～９月为中毒高峰时间。认为性别、年龄、季节等为引起ＯＰＰ的主要相关因素,这为ＯＰＰ的预防提供了参考依据。     

264例急性中重度中毒临床与流行病学分析

目的分析我院264例急性中、重度中毒患者流行病学及临床特点,为急性中毒防治工作提供科学依据。方法对2008年6月～2011年6月温州医学院附属第二医院264例急性中重度中毒患者性别、年龄、脏器损伤情况等12项内容进行回顾性分析。结果所调查患者男女比例1.9∶1,高发年龄段为20～49岁,主要为无业人员(34.8%),中毒原因以自杀为主(164例),毒物类型前三位依次是有机磷农药(32.6%)、抗精神药物(12.2%)和镇静安眠药(11.5%),中、重度中毒患者比例1.7∶1,多脏器功能障碍发生率35.6%,最常受累器官为肺(38.6%)和脑(36.0%),中毒死亡率5.3%。结论本研究提供了该院急性中、重度中毒流行病学及临床特点的基本资料,为本地区急性中毒防治工作提供有用信息。     

ICU综合救治重度有机磷农药中毒并呼衰(附84例报告)

目的:探讨急性有机磷农药中毒合并呼吸衰竭(ASOPP)患者在ICU内以机械通气为主的综合性防治方法及其临床价值.方法:对我院1995年7月至2005年6月连续10年两个不同时期的ASOPP合并ARF 162例的治疗模式、方法和效果进行回顾性对比分析.2000年前5年分别由急诊科、消化内科、肾内科常规治疗78例,2000年7月后转入ICU进行机械通气为主的综合性防治方法84例.结果:两个不同时期抢救成功率分别为88.33%、91.16%、病死率分别为16.66%和8.33%.结论:ICU内以机械通气为主的综合治疗模式和方法能减少病死率,值得有条件的医院采纳.     

56例有机磷农药中毒急救处理分析

目的总结有机磷农药中毒的急救处理经验.方法回顾性分析1996年6月～2004年8月47例有机磷农药中毒急救处理的临床资料.全部患者均应用阿托品和氯磷定治疗,10例患者接受呼吸机支持治疗.结果 5例患者死亡,总死亡率为10.6%.需要接受呼吸机支持治疗的10例患者中,1例死于室性心动过速,1例死于呼吸道感染.结论正确应用阿托品、氯磷定以及维持呼吸功能是抢救有机磷中毒成功率的关键.     

意外伤害外因及社会预防探讨

这次调查的目的在于分析重庆币九龙坡区意外伤害的外因及分布情况。选用该区1990～1997年意外伤害住院患者出院登记资料,按ICD9编码进行分类统计。结果显示：在各类疾病中,意外伤害约占10．6％。意外伤害主要外因依次为：意外跌伤、交通事故、他杀、机器事故、自杀、坠物砸伤和意外中毒。交通事故伤主要为乡村男性（占40．8％）。意外跌伤、坠物砸伤和机器事故伤主要为城镇男性。他杀和意外中毒主要为乡村青年男性。自杀主要为乡村青年女性（占50．9％）。因此,加强安全教育,完善安全措施,势在必行。     

Electrocardiographic abnormalities in aluminium phosphide poisoning with special reference to its incidence, pathogenesis, mortality and histopathology

Ninety-five patients out of total 190 cases of aluminium phosphide (ALP) poisoning, who exhibited ECG changes were studied for incidence, type and pattern of ECG abnormalities, their effect on mortality and their relationship with histopathology of heart. Its incidence in the present study was 50%. The arrhythmias, conduction disturbances and ischaemic pattern occurred more or less in equal frequency. Certain ECG abnormalities which had not been reported previously ie, early repolarisation syndrome, varied sino-atrial blocks, bradycardia-tachycardia syndrome and electrical alternans were observed in this study. The clinical profile of these cases was similar irrespective of whether patients had ECG abnormalities or not. Shock was the cardinal feature. There was no effect of ECG abnormalities on mortality. The mortality which was otherwise high, depended upon severity of poisoning, dose of poison consumed, duration of shock, failure of response of shock to resuscitative measures and severe hypomagnesaemia. The pathogenesis of ECG abnormalities is still obscure. Hypomagnesaemia was observed in all the 18 cases studied, irrespective of ECG abnormalities. However, these were common when hypomagnesaemia was severe. Hypoxaemia and shock were not the contributory factors for these abnormalities. Autopsy revealed stereotyped histopathological changes of toxic myocarditis independent of ECG findings.     

Trends in Suicide by Poisoning in China 2000-2006： Age, Gender, Method, and Geography

Objective This study analyzed patterns of suicide and suicide attempts by poisoning as reported through a national poison control system for the purpose of improving intervention and prevention. Methods During the period of 2000 to 2006, 6440 cases of poisoning suicide were reported to the telephone consultation service system of The National Center for Poisoning Control （Chinese Center for Disease Control and Prevention）. Among these records, 4728 cases had completed data for this analysis in terms of age, sex, trend of time and location, and type of poisons. Results There were 60.6% female cases with the age from 10 to 90 years old. The age of cases from 20 to 39 years accounted for 54.5% of all age groups. Both the numbers and percentage in record related to poisoning consultation of oral poisoning suicide showed an increasing tendency during the 7 years. In particular, there was a drastic increase from 2004 to 2006. In addition, the high frequency of cases occurred from May to October. Hebei, Shandong, Henan, and Anhui Provinces had the highest number of cases. Pesticide poisonings were the most common method in these cases of consultation for suicide and suicide attempts. Conclusion This study describes epidemiological characteristics in the oral poisoning suicide cases and provides scientific basis for suicide prevention interventions.     

儿童中毒的原因分析及护理干预

目的 探讨儿童中毒的原因和护理干预措施。方法 采集儿童中毒病例282例进行回顾性分析，以进行有目的、有计划的护理干预。结果 以2～7岁发生率高，占72．6％，在儿童中毒原因中自杀和自慰性服药中毒的比例呈上升趋势。结论 儿童中毒有可预防性，应重视护理干预工作。     

98例有机磷中毒患者的脑电图改变

目的：探讨有机磷农药中毒的脑电图改变。方法：对98例急性有机磷农药中毒病人进行脑电图描记，结果：脑电图异常93例，总异常率为94．9％，结论：脑电图是及时评估病情的有效检查方法。     

应用APACHEⅡ评分对急性有机磷农药中毒患者氯解磷定总用量估模的临床研究

目的:对有机磷农药急性中毒患者应用氯解磷定总用量估模值的救治方案进行治疗,观察其疗效。方法:对91例重度急性有机磷农药中毒(AOPP)患者就行救治,取中毒后第一个24小时内,病情最严重时的急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)的分值(X),代入(?)=-43.4+4.7X,计算出PAM.Cl总用量((?)),并按大量突击疗法应用至临床治愈,验证上述公式。结果:急性有机磷农药中毒患者的救治过程表明,氯解磷定实际总用量与总用量估模值一致。结论:通过APACHEⅡ评分系统初步估模出急性有机磷农药中毒患者氯解磷定总用量的值,是准确的。公式(?)=-43.4+4.7X是指导急性有机磷农药中毒时氯解磷定总量的有效方法,有利于指导用药。     

Acute poisoning in children. Cases hospitalized during a three-year period in Trinidad

The aim of this study is to describe the epidemiological features of acute poisoning in children less than 16 years old who were admitted to a paediatric hospital in north Trinidad. The specific objectives included the determination of the age range most susceptible to poisoning, which agents are mainly responsible, an examination of the need for preventive strategies and educational programmes as well as to evaluate the need for a poison control centre in the country. Data were extracted from the medical records of 169 patients (83 males (49%) and 86 females (51%) with acute poisoning during the period of January 1998 to December 2000. The results revealed that the majority of cases of poisoning were accidental (84.6%), suicide (11.2%) and forced poisoning (4.1%). The largest category of poisoning was a miscellaneous group (24.8%) followed by the drug category (21.8%), kerosene (19.5%), pesticides (15.9%) and bleach (9.4%). Paraquat ingestion constituted 5.3% of cases. The highest prevalence of acute poisoning occurred within the age group of 0-4 years (69.2%), followed by the age group of 10-13 years (13.6%), 5-9 years (9.4%) and the age group with the lowest incidence was 14-16 years (7.6%). The only fatality was a female (10-13 year-group) and this was due to suicidal ingestion of paraquat. All other cases were treated and subsequently discharged. The frequency of accidental poisoning in Trinidad merits more widespread public education aimed at preventing exposure to toxic substances while increasing the use of deterrents such as child-resistant containers.     

广州市白云区1998～2004年食物中毒情况分析

目的了解广州市白云区食物中毒发生的动态情况、中毒发生特点和规律,提出相应的控制措施。方法收集全区1998—2004年食物中毒统计报表及个案调查资料进行统计分析。结果7年来共发生食物中毒85起,中毒人数1414例,死亡23例。年平均12起,中毒人数202例,死亡3例。食物中毒发生的起数和中毒人数总体呈上升趋势。中毒食品以植物性食物为主,农药等化学物是导致中毒的主要致病因素,中毒发生场所以集体食堂为主。结论加强食品卫生管理和宣传教育是预防食物中毒的关键措施。     

Alcohol, firearms, and suicide among youth. Temporal trends in Allegheny County, Pennsylvania, 1960 to 1983

The death certificates and coroners' reports for all suicides, undetermined causes of death, and questionable accidents were obtained from the Pennsylvania Department of Vital Statistics for 10- to 19-year-old residents of Allegheny County, Pennsylvania, from 1960 to 1983. During the 24-year study period, 159 cases of definite suicide and 38 cases of likely suicide were noted. The suicide rate increased markedly among youth during the study period, particularly among white males aged 15 to 19 years, and was not due to changes in classification procedures over time. The suicide rate by firearms increased much faster than the suicide rate by other methods (2.5 vs 1.7-fold). The proportion of suicide victims who had detectable blood alcohol levels rose 3.6-fold from 12.9% in 1968 to 1972 to 46.0% in 1978 to 1983. Suicide victims who used firearms were 4.9 times more likely to have been drinking than were those who used other methods of suicide. The availability of firearms and the increased use of alcohol among youth may have made a significant contribution to the increase in the suicide rate among the young.     

有机磷农药中毒并发呼吸衰竭影响因素临床研究

目的 :研究有机磷农药中毒(OPP)患者并发呼吸衰竭的影响因素.方法 :以169例有机磷农药中毒患者为研究对象,根据血气分析检查结果分为呼吸衰竭组86例,非呼吸衰竭组83例,比较两组一般情况、临床表现,分析呼吸衰竭的诱发因素.结果 :有机磷农药中毒患者呼吸衰竭经多因素logistic回归分析,高中毒剂量、服农药至洗胃时间延长、高APACHEⅡ评分、高AMY均为有机磷农药中毒患者呼吸衰竭独立危险因素,CHE升高为有机磷农药中毒患者呼吸衰竭的保护性因素,均有统计学意义.结论 :研究急性有机磷农药中毒患者呼吸衰竭的独立危险因素有重要的临床应用价值.     

Pattern of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital

Objective: This study was conducted to determine the pattern and severity of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal (KMCTH). Design: Retrospective observational study. Materials and methods: Hospital records of all admissions to the Emergency Department of Kathmandu Medical College Teaching Hospital (KMCTH) following acute poisoning were revised and all data from February 2007 to February 2008 were analyzed retrospectively. Results: This retrospective observational study was performed on 148 cases of poisoning who attended Emergency Department of KMCTH over a period of one year. The overall male to female ratio was 1.05:1. Poisoning was most common in the age group 21-30 years (40.5%). The most common causes of poisoning in adults were organophosphorous compounds and in children was kerosene oil. Oral route (79.05%) was the most common route of administration. 66.2% of cases were intentional poisoning for suicidal attempt. Students (43.9%) and service holders (18.9%) were commonly involved in poisoning. Conclusion: It was seen that adult between 21-30 years of age were more prone to suicidal poisoning with organophosphorous compounds and children of 1-10 years of age were more susceptible to accidental poisoning with kerosene oil. Key words: Organophosphorous; Poisoning; Suicide; Kerosene.