广西农村急性中毒发生和救治现状与对策研究

目的：探讨广西农村急性中毒的发生情况、救治现状及其对策。方法收集2005～2009年广西36家市级医院、12家县级医院、15家乡镇卫生院收治的6015例中毒患者资料，对农村急性中毒的发病情况、救治方法及效果等进行分析。结果 6015例急性中毒患者中，农村急性中毒患者3702例，占61．84％，其发病例数平均每年以13．03％的速度递增。51家乡镇卫生院中，开展急性中毒救治仅13家（25．49％）；市、县、乡级医院救治的中毒患者分别为1483例、1543例、676例。对农村中毒患者进行现场处置701例（18．94％），进行排毒、解毒和对症处理分别为2367例（63．94％）、2824例（76．28％）、1791例（48．38％），进行血液处理仅249例（6．73％）。三级医院中，乡镇医疗单位采用血液净化处理的比例最低（P＜0．05），其他处理方法的比例均高于市、县级医疗单位（P＜0．05）。3670例有救治效果记录的患者中，县级医疗单位的治愈率最高，后遗症、死亡率最低，市、乡级医疗单位的治愈率接近，乡级医疗单位死亡率最高。结论广西农村急性中毒发病例数增速快，但救治条件缺乏、救治技术落后，应结合广西医疗条件的分布现状，采取以“乡为基础、县为中心、市为后盾”的发展方向。

Incidence and treatment of acute poisoning in rural area of Guangxi:current situation and strategies

Objective To investigate the current situation of the incidence and treatment of acute poisoning in rural area of Guangxi,and to explore the strategies.Methods The data of 6015 patients with acute poisoning between 2005 and 2009 were collected from 36 city hospitals,12 county hospitals and 15 town hospitals.And a survey on the incidence,treatment and curative effect was conducted in patients with acute poisoning from rural area .Results Of 6015 patients with acute poisoning ,3 702 were from rural area ,accounting for 61.84%,and the cases increased at the speed of 13.03%every year.The therapy for acute poisoning was performed in only 13 of 51 town hospitals(25.49%).The numbers of patients with acute poisoning treated by city hospital ,county hospital and town hospital were 1 483, 1 543 and 676,respectively.Among these rural patients with acute poisoning ,701 received the treatment on the spot ,accounting for 18.94%, the cases accepted the therapies of toxin cleaning ,toxicity elimination and symptomatic treatment amounted to 2 367(63.94%),2 824 (76.28%) and 1 791(48.38%),respectively,and only 249(6.73%) were given hemotherapy .Town hospital had the lowest proportion of carrying out blood purification among city ,county and town hospitals(P<0.05),and higher proportions of other therapies compared to city or county hospital(P<0.05).Of 3 670 cases with records of therapeutic efficacy ,county hospital obtained the highest recovery rate and the lowest rates of sequela and death .The recovery rate of city hospital was similar to that of town hospital ,and the mortality of town hospital was the highest .Conclusion The cases of acute poisoning increases rapidly in rural area of Guangxi where lacking therapy provision and therapeutic technique .The development direction with ′the township as base ,the county as center and the city as backup′should be adopted according to the current distribution of medical condition in Guangx .