Herranz M, Clerigué N
Urgencias de Pediatría, Hospital Virgen del Camino, 31008 Pamplona, Spain.
An Sist Sanit Navar. 2003;26 Suppl 1:209-23.
Poisonings during childhood account for 0.3-0.4% of consultations in the emergency pediatric services and constitute a pathology that must be born in mind, because of its frequency, its consumption of resources, its repercussion on the surrounding milieu and the possibility of its prevention. With respect to its epidemiology, the first cause of pediatric poisoning are medicines, with paracetamol outstanding as the most frequent cause of poisoning. In the second place in order of frequency we find products of household use, although their importance in pediatric toxicology rests basically on the fact that some of these products, such as cosmetics, can result in accidental ingestion, almost exclusively involving children. Hospital procedure concerning the poisoned child involves a first phase of life support and stabilization measures, followed by identification of the toxin and measures of detoxification where necessary. Given the broad scope of the issue and the impossibility of covering all of pediatric toxicology, this article describes its epidemiology in our milieu and some considerations are made with respect to dealing with the most frequent or characteristic poisonings involving children. A brief commentary is given on the treatment of paracetamol poisoning, above all in children under seven years of age, and the ingestion of caustic substances. Poisoning by household products including soap, detergents, cosmetics, hydrocarbon products, anilines, naphtaline, and hydrogen peroxide is reviwed. Finally, methaemoglobinaemia's physiopathology, aetiology, clinical picture, diagnosis and treatment is reviewed.
儿童中毒占儿科急诊就诊病例的0.3%-0.4%，是一种必须予以重视的病症，这是鉴于其发病频率、资源消耗、对周围环境的影响以及预防的可能性。关于其流行病学，儿科中毒的首要原因是药物，对乙酰氨基酚是最常见的中毒原因。按频率排序，其次是家用产品，不过它们在儿科毒理学中的重要性主要在于其中一些产品，如化妆品，可能导致意外摄入，几乎只涉及儿童。医院对中毒儿童的处理程序包括生命支持和稳定措施的第一阶段，随后是毒素鉴定以及必要时的解毒措施。鉴于该问题的广泛范围以及涵盖所有儿科毒理学内容的不可能性，本文描述了其在我们环境中的流行病学情况，并对处理涉及儿童的最常见或典型中毒情况进行了一些思考。对乙酰氨基酚中毒的治疗，尤其是七岁以下儿童的治疗以及腐蚀性物质的摄入进行了简要评论。对包括肥皂、洗涤剂、化妆品、碳氢化合物产品、苯胺、萘和过氧化氢在内的家用产品中毒情况进行了综述。最后，对高铁血红蛋白血症的生理病理学、病因、临床表现、诊断和治疗进行了综述。
