云南省热带地区1364例急性中毒病例分析

目的 探讨云南省热带地区急性中毒事件的发生规律和特点,为制定预防和控制措施提供依据。方法 以云南省的热带地区某三级综合医院为对象,从该医院信息系统中调取2013年1月1日—2018年12月31日出院的急性中毒病例数据,对中毒人群、中毒类型、中毒发生的季节及治疗效果等进行分析。结果 该院6年期间共收治急性中毒1 364例,各年龄段均有发生,其中20~<50岁占总病例的60.19%。导致中毒的物质中,农药、化学药物、草药及植物性中毒分别占总量的48.39%、16.72%和11.80%,其中百草枯、有机磷农药、野生菌、乌头碱、杀鼠剂分别为244例、189例、96例、90例、89例,居前5位。导致中毒的热带毒性植物品类繁多。中毒病例发生在雨季的占总量的57.26%,其中野生菌中毒几乎全部发生在雨季,农药中毒雨季也显著高于旱季。治疗效果上,百草枯治疗效果差,出院时死亡和未愈病例占44.90%,有机磷农药死亡率也高达8.47%。结论 云南省热带地区急性中毒发生率高,其中农药类、野生菌、有毒植物中毒问题突出。应加强宣传,提高对急性中毒的关注,完善应急处理体系,以期有效地降低急性中毒事件的发生及危害。

Analysis of 1 364 cases of acute poisoning in tropical areas of Yunnan

Objective To investigate the occurrencnd characteristics of acute poisoning events ine a the tropical regions of Yunnan Province,we provide evidence for prevention and control measures.Methods A three-level general hospital in typical tropical area of Yunnan Province was selected as the research object.All the cases of acute poisoning during 2013.01.01 to 2018.12.31 were retrieved from the information system to analyze the characteristics of population,the type of poisoning,the season of poisoning event and treatment effect.Results A total of 1 364 cases of acute poisoning were collected during the 6 years.Acute poisoning occurred in all age groups,and 20 to 50 age groups accounted for 60.19% of all cases.On poisoning substances,agricultural chemicals,drugs,herbal medicines and plant poisoning accounted for 48.39%,16.72% and 11.80% respectively.Among them,paraquat,organophosphorus pesticide,wild mushroom,aconitine and rodenticide were 244,189,96,90,89 cases respectively,which took the top 5.A wide range of tropical poisonous plants that caused acute poisoning.Almost all the wild mushroom poisoning cases and 57.26% of all the poisoning cases occurred in the rainy season.Also,much more cases of agricultural chemicals poisoning occurred in rainy season than the dry season.In terms of therapeutic effect,the treatment effect of paraquat was proven to be poor,for the death and unhealed cases got to 44.90% when discharge.The mortality rate of organophosphorus pesticides was also as high as 8.47%.Conclusions The incidence of acute poisoning in tropical areas of Yunnan Province is still high,especially caused by agricultural chemicals,wild mushroom,herbal medicines and poisonous plants.It is necessary to strengthen publicity and improve the emergency response system,in order to effectively reduce the occurrence and harm of acute poisoning accidents.