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入住医学重症监护病房的急性中毒病例

[Cases of acute poisoning admitted to a medical intensive care unit].

作者信息

Viertel A, Weidmann E, Brodt H R

机构信息

Medizinische Klinik IV/Nephrologie, Johann Wolfgang Goethe-Universität Frankfurt am Main.

出版信息

Dtsch Med Wochenschr. 2001 Oct 19;126(42):1159-63. doi: 10.1055/s-2001-17890.

Abstract

BACKGROUND AND OBJECTIVE

Because of the paucity of information on the epidemiology of acute poisoning requiring intensive medical care, all such patients treated on the medical intensive care unit of the university hospital in Frankfurt am Main, Germany, between January 1993 and December 1999, were retrospectively evaluated.

PATIENTS AND METHODS

Of the total of 6211 patients, 147 (80 women, 67 men, mean age 41 years, 2,3 %) were treated for acute intoxication in the intensive care unit.

RESULTS

Reasons for admission to the intensive care unit were the need for ventilator treatment or intensive monitoring of vital functions. 52 % of the patients (n = 76) had attempted suicide, most of them using anti-depressive drugs (n = 19), paracetamol (n = 16), or benzodiazepines (n = 9). Two patients (2,6 %) died. 48 % of the patients (n = 71) were admitted because of accidental poisoning. Leading toxic agents in this group were heroin (n = 19), alcohol (n = 18) and digitalis (n = 12). 11 patients had taken herbicides, animal poisons or chemicals used at work or for house cleaning. In this cohort, three i. v. drug abusers (4,2 %) had died. Depending on the agents used, a variety of treatments (charcoal, antidots, extracorporal therapy) were undertaken.

CONCLUSION

Due to excellent care in the prehospital phase and in the emergency room the number of patients requiring treatment on the intensive care unit was rather low. The mortality was in the range of other reports.

摘要

背景与目的

由于关于需要重症医疗护理的急性中毒流行病学信息匮乏,对1993年1月至1999年12月期间在德国美因河畔法兰克福大学医院医疗重症监护病房接受治疗的所有此类患者进行了回顾性评估。

患者与方法

在总共6211名患者中,有147名(80名女性,67名男性,平均年龄41岁,占2.3%)在重症监护病房接受急性中毒治疗。

结果

入住重症监护病房的原因是需要呼吸机治疗或对生命功能进行强化监测。52%的患者(n = 76)曾试图自杀,其中大多数使用抗抑郁药(n = 19)、对乙酰氨基酚(n = 16)或苯二氮䓬类药物(n = 9)。两名患者(2.6%)死亡。48%的患者(n = )因意外中毒入院。该组中主要的有毒物质是海洛因(n = 19)、酒精(n = 18)和洋地黄(n = 12)。11名患者摄入了除草剂、动物毒素或工作或家庭清洁中使用的化学品。在这个队列中,有三名静脉吸毒者(4.2%)死亡。根据所使用的毒物,采取了各种治疗方法(活性炭、解毒剂、体外治疗)。

结论

由于院前阶段和急诊室的优质护理,需要在重症监护病房接受治疗的患者数量相当低。死亡率与其他报告的范围相符。

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