Yüksekkaya Hasan, Gumus Meltem, Yucel Aylin, Energin Meltem, Demirci Serafettin
From the Departments of Pediatric Gastroenterology.
Pediatrics, and.
Pediatr Emerg Care. 2019 Mar;35(3):216-219. doi: 10.1097/PEC.0000000000001450.
Mistaken ingestion of all manner of toxic matter is common in childhood, but poisoning with fireworks and matchsticks is rare. Fireworks usually contain 10% yellow phosphorus and 50% potassium chlorate. Potassium chlorate is an extremely reactive and toxic agent that is used in fireworks and matchstick heads.
Eleven cases (7 females and 5 males; median age, 36 months [ranging from 24 to 48 months]) of poisoning after ingestion of fireworks and matchstick(s), between February 2008 and June 2014, were reviewed.
The most common initial symptom was vomiting except for 2 cases in this group. Biochemical tests indicated that hyperphosphatemia was present in all patients, 8 patients (72.7%) had subclinical hepatic injury, 1 (9%) had acute hepatic failure, and 2 patients had no clinical or biochemical evidence of hepatic damage. Three patients had renal impairment, but none of them required dialysis. All of the patients recovered with supportive therapy except for 2 cases. One patient underwent cadaveric liver transplantation, whereas the other died because of circulatory dysfunction and respiratory failure due to pulmonary alveolar hemorrhage.
Without prompt intervention, poisoning with fireworks carries high morbidity and mortality in children. It can cause pulmonary hemorrhage, in addition to other organ damage, including liver and kidney. Hyperphosphatemia is common, as it was seen in all of the study patients.
儿童误服各种有毒物质的情况很常见，但因烟花和火柴中毒的情况却很罕见。烟花通常含有10%的黄磷和50%的氯酸钾。氯酸钾是一种极具反应性和毒性的物质，用于烟花和火柴头。
回顾了2008年2月至2014年6月期间11例（7名女性和5名男性；中位年龄36个月[24至48个月]）因误食烟花和火柴而中毒的病例。
除该组中的2例患者外，最常见的初始症状是呕吐。生化检查表明，所有患者均存在高磷血症，8例患者（72.7%）有亚临床肝损伤，1例（9%）有急性肝衰竭，2例患者无肝损伤的临床或生化证据。3例患者有肾功能损害，但均无需透析。除2例患者外，所有患者经支持治疗后均康复。1例患者接受了尸体肝移植，另1例因肺泡出血导致循环功能障碍和呼吸衰竭死亡。
如果不及时干预，儿童烟花中毒的发病率和死亡率很高。除了其他器官损伤，包括肝脏和肾脏，它还会导致肺出血。高磷血症很常见，在所有研究患者中均有发现。
