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棘手情况:向毒物控制系统报告的氰基丙烯酸酯暴露情况。

Sticky situations: cyanoacrylate exposures reported to a poison control system.

作者信息

Carstairs Shaun D, Koh Cynthia, Qian Lily, Qozi Mariam, Seivard Grant, Cantrell F Lee

机构信息

a Division of Medical Toxicology, Department of Emergency Medicine , University of California , San Diego , CA , USA.

b California Poison Control System , San Diego , CA , USA.

出版信息

Clin Toxicol (Phila). 2017 Nov;55(9):1001-1003. doi: 10.1080/15563650.2017.1327067. Epub 2017 May 23.

Abstract

INTRODUCTION

Cyanoacrylate (Super Glue) exposures are commonly reported to poison control centers, but little has been published in the medical literature regarding these exposures. We sought to characterize cyanoacrylate exposures reported to a poison control system.

METHODS

We performed a retrospective review of a poison system's database for all cases of single-substance human exposure to cyanoacrylate-containing products from 2005 to 2015. Data collected included age, gender, route of exposure, clinical effects, treatments recommended and medical outcome.

RESULTS

There were a total of 893 patients, 505 (56.6%) of which were female. Patient ages ranged from 6 months to 88 years with a median of 11 years. The vast majority of exposures (n = 871, 97.5%) were unintentional, but a small number of exposures (n = 22, 2.5%) were due to intentional misuse (such as trying to stop a bleeding cut) or malicious intent (such as purposefully gluing a person's eyes shut as a prank). Routes of exposure included: ingestion, n = 337 (37.7%); ocular, n = 322 (36.1%); dermatologic, n = 285 (31.9%); inhalation, n = 16 (1.8%); nasal, n = 1 (0.1%); and otic, n = 1 (0.1%); some patients had multiple routes of exposure. Treatments recommended by the poison center included irrigation (n = 411), petroleum jelly (n = 143), mineral oil (n = 131), topical antibiotic ointment (n = 82), peanut butter (n = 6), acetone (n = 4) and WD-40 (n = 2). A total of 657 patients (73.6%) were managed on-site, while 236 (26.4%) were seen in a health care facility. Among all exposures, effects were classified as none (n = 287), minor (n = 529) and moderate (n = 77). No major effects or deaths were reported.

CONCLUSIONS

In this case series, the majority of cases occurred in children and most exposures did not result in significant morbidity. Notably, there was wide variation in terms of recommended treatments; further study is needed to determine the optimal treatment method and to standardize poison center recommendations for treating patients with cyanoacrylate exposures.

摘要

引言

氰基丙烯酸酯(强力胶)暴露事件经常被报告至中毒控制中心,但医学文献中关于此类暴露事件的报道却很少。我们试图对报告至一个中毒控制系统的氰基丙烯酸酯暴露事件进行特征描述。

方法

我们对一个中毒系统的数据库进行了回顾性研究,纳入了2005年至2015年所有单物质人体暴露于含氰基丙烯酸酯产品的病例。收集的数据包括年龄、性别、暴露途径、临床症状、推荐的治疗方法及医疗结局。

结果

共有893例患者,其中505例(56.6%)为女性。患者年龄范围为6个月至88岁,中位数为11岁。绝大多数暴露事件(n = 871,97.5%)为意外暴露,但有少数暴露事件(n = 22,2.5%)是由于故意误用(如试图止住流血的伤口)或恶意行为(如作为恶作剧故意粘住他人眼睛)。暴露途径包括:摄入,n = 337例(37.7%);眼部,n = 322例(36.1%);皮肤,n = 285例(31.9%);吸入,n = 16例(1.8%);鼻腔,n = 1例(0.1%);耳部,n = 1例(0.1%);一些患者有多种暴露途径。中毒控制中心推荐的治疗方法包括冲洗(n = 411)、凡士林(n = 143)、矿物油(n = 131)、外用抗生素软膏(n = 82)、花生酱(n = 6)、丙酮(n = 4)和WD - 40(n = 2)。共有657例患者(73.6%)在现场得到处理,而236例(26.4%)在医疗机构就诊。在所有暴露事件中,症状被分类为无(n = 287)、轻微(n = 529)和中度(n = 77)。未报告有严重症状或死亡事件。

结论

在这个病例系列中,大多数病例发生在儿童中,且大多数暴露事件未导致显著的发病情况。值得注意的是,推荐的治疗方法差异很大;需要进一步研究以确定最佳治疗方法,并规范中毒控制中心对氰基丙烯酸酯暴露患者的治疗建议。

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