综合性医院急诊农药中毒的调查

目的 探讨急诊农药中毒的特点。方法 有条件地选择25家综合性医院急诊科作为调查点,其中省市级医院14家、县级医院11家;观察对象为在2001年7月1日至2002年6月30日观察期内到25家医院急诊救治的首诊农药中毒患者(包括初诊和转诊),对其进行调查并分析其特点。结果25家医院急诊科共救治农药中毒患者2 261例,居同期急诊科救治各类中毒总例数的第三位;农药中毒患者的男女性别比为1:1.47;在1 618例初诊患者中,有43.9％的病例(710例)使用救护车急诊;以有意接触而致中毒为主要原因,占68.3％;女性的有意接触占75.8％;在4个年龄段中,15-34岁是农药中毒的急诊高峰年龄段,各年龄段农药中毒占本年龄段总中毒的比例明显不同,以0-14岁组居高,其中又以1-4岁儿童最高,占65.9％;98.2％的病例需要急救处理,经急诊救治后,患者中52.4％转住院治疗;中毒对象依次为农民、家务劳动者、学生和学龄前儿童等;杀虫剂中毒居首位,占60.1％,急诊观察农药中毒病死率为3.9％(不包括由急诊科转住院、ICU病房继续治疗患者的结局);60.8％农药中毒患者来自县医院救治的病例,居县医院救治各类中毒总例数的首位。结论 普及宣传科学、安全、合理使用和贮存农药的知识,减少非生产性农药中毒,是控制、减少农药中毒的关键。

A survey of emergency treatment of pesticides poisoning in comprehensive hospitals

Objective To seek the character istics of pesticide poisoning in emergency departments. Methods Twenty-five hospitals were selected. Among them, they were 14 province or city level and 11 county level . The object of study was the patients with pesticide poisoning who were first visit to a doctor( including transfer to the above emergency departments of hospitals) from July 1,2001 to June 30,2002. Results There were 2 261 cases of pesticide poisoning that ranked third place of total acute poisoning cases at the same period. Gender ratio was 1 male to 1.47 female. Among 1 618 patients who first visited to emergency departments (excluding transfer), 43.9 % were by emergency ambulance. 68.3 % of total cases were caused by intentional exposure to pesticides, of which female accounted for 75 .8 % . Young people aged 15 - 34 years accounted for 47.5 % of all cases. Children (0 - 14 years) also had relatively high pesticide poisoning rates,particularly an accident pesticide poisoning for 1 - 4 years old children accounted for 65.9% of total acute poisoning in the age group.98.2% of all cases needed urgent medical treatment,and 52.4% were hospitalized.The leading occupation of patients was farmers followed by housekeepers, students and preschoolers. Insecticides poisoning accounted for 60.1 % of all pesticides. The fatality rate in emergency department was 3.9% .60.8% case was collected from county hospital.Pesticide poisoning rank first place of total acute poisoning cases in county hospital. Conclusion A safety education of Knowledge Attitude Practice(KAP) is an effective measure for preventing pesticide poisoning.