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[2009年波兰乙二醇和甲醇急性中毒的选定数据]

[Selected data of acute intoxications with glycol and methanol in Poland in the year 2009].

作者信息

Sein Anand Jacek, Swiderska Aleksandra, Pach Janusz, Burda Piotr

机构信息

Zakład Toksykologii Klinicznej, Gdańskiego Uniwersytetu Medycznego.

出版信息

Przegl Lek. 2011;68(8):453-8.

Abstract

BACKGROUND

There are no reliable studies in Poland evaluating the scale of acute intoxications with different types of xenobiotics.

OBJECTIVE

The aim of the study was to evaluate selected problems referring to the patients intoxicated with glycol and methanol, who were given the medical treatment in all Toxicological (TUs) and Intensive Care Units (ICUs), having contract with Polish National Fund of Health, in the year 2009.

METHODS

All cases of acute intoxications treated in Polish hospitals in 2009 and reported to the Polish National Fund of Health were included to the analysis. To further analysis were chosen only those patients, whose main diagnosis or comorbidities were coded as T51.1 or T52.3 according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision and, according to the state of health, patients were treated in TUs and ICUs. All the cases, in which intoxication was not the main health problem were excluded.

RESULTS

There were 85 398 acute intoxications in Poland in 2009, 470 of them referred to glycol and methanol poisonings. 192 patients were treated in TUs and ICUs. The most common methods of therapy in those units were extracorporeal toxin removal (60.2% in TUs and 62.5% in ICUs) and conservative treatment (39.8% in TUs and 37.5% in ICUs). The mortality rate in glycol and methanol poisonings in TUs and ICUs were 24.2%, and 56.3% respectively. In the conservatively treated group the mortality rates in TUs and ICUs were 23.5%, and 66.7% respectively, while in extracorporeal toxin removal group the mortality rates in TUs and ICUs were 24.7%, and 50% respectively. The authors also observed two regions (Maków Mazowiecki and Słubice), in which the amount of glycol and methanol intoxications was much higher than in the rest part of the country.

CONCLUSIONS

  1. All the cases of acute intoxications of glycol and methanol should be consulted with Polish Poison Control Centers. 2. It is necessary to establish diagnostic and treatment protocols for intoxicated patients in Poland. 3. There is a strong need for popularization of the modern methods of glycol and methanol poisonings therapy and increasing the availability of modern antidotes. 4. It is necessary to monitor diagnostics, treatment and mortality rate of glycol and methanol intoxicated patients in all types of hospital units in Poland. 5. There is a need of further toxicological education of medical students and doctors as well. 6. The cases of abnormally high rate of glycol and methanol intoxications in some hospitals should be investigated.
摘要

背景

在波兰,尚无可靠研究评估不同类型外源性物质所致急性中毒的规模。

目的

本研究旨在评估2009年在所有与波兰国家卫生基金有合作的毒理学单位(TUs)和重症监护病房(ICUs)接受治疗的乙二醇和甲醇中毒患者的一些相关问题。

方法

纳入2009年在波兰医院接受治疗并上报至波兰国家卫生基金的所有急性中毒病例进行分析。仅选择那些主要诊断或合并症根据《国际疾病和相关健康问题统计分类》第10次修订版编码为T51.1或T52.3,且根据健康状况在毒理学单位和重症监护病房接受治疗的患者作进一步分析。排除所有中毒并非主要健康问题的病例。

结果

2009年波兰有85398例急性中毒病例,其中470例为乙二醇和甲醇中毒。192例患者在毒理学单位和重症监护病房接受治疗。这些科室最常用的治疗方法是体外毒素清除(毒理学单位为60.2%,重症监护病房为62.5%)和保守治疗(毒理学单位为39.8%,重症监护病房为37.5%)。毒理学单位和重症监护病房中乙二醇和甲醇中毒的死亡率分别为24.2%和56.3%。在保守治疗组中,毒理学单位和重症监护病房的死亡率分别为23.5%和66.7%,而在体外毒素清除组中,毒理学单位和重症监护病房的死亡率分别为照组24.7%和50%。作者还观察到两个地区(马库夫马佐维茨基和斯武比采),乙二醇和甲醇中毒的数量远高于该国其他地区。

结论

  1. 所有乙二醇和甲醇急性中毒病例均应咨询波兰中毒控制中心。2. 有必要在波兰为中毒患者制定诊断和治疗方案。3. 迫切需要推广乙二醇和甲醇中毒的现代治疗方法并增加现代解毒剂的可及性。4. 有必要监测波兰各类医院单位中乙二醇和甲醇中毒患者的诊断、治疗及死亡率。5. 医学生和医生也需要进一步接受毒理学教育。6. 应对一些医院中乙二醇和甲醇中毒发生率异常高的情况进行调查。

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