埃及上埃及地区儿童急性有机磷中毒的临床特征和转归：一项横断面研究。
Clinical profile and outcome of acute organophosphate poisoning in children of Upper Egypt: a cross-sectional study.
机构信息
Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt.
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.
出版信息
BMC Pediatr. 2021 Feb 26;21(1):98. doi: 10.1186/s12887-021-02563-w.
BACKGROUND
Organophosphates are one of the most common agents of poisoning in developing countries including Egypt. Due to lack of data about characteristics of organophosphates poisoning in our localities, we aimed to evaluate its clinical pattern and factors affecting outcome.
METHODS
It was a cross-sectional study conducted in South valley University hospital between January 2019 and December 2019. It included all children ≤16 years of age presented with organophosphates poisoning. Diagnosis was performed from the history taken from the patient's relatives and presenting symptoms. Demographic data, mode and route of poisoning, time from exposure to presentation, clinical symptomatology, grading and routine investigations were evaluated in addition to treatment taken and outcome.
RESULTS
During the study period, 108 children; mean age was 7.95 ± 4.11 years (range 1. 5-16 years) presented with organophosphorous poisoning. Sixty five (60%) cases were females and 43 (40%) were males. Unintentional acts (87%) were detected more than suicidal (13%) and inhalation route (63.8%) more than ingestion (36. 2%). Miosis was the most frequent clinical sign (100%) followed by respiratory distress (77.7%). Regarding time of presentation to emergency department, 43 (40%) cases were presented within 6 h while others presented more than 6 h post-exposure. Mechanical ventilation (MV) was needed for 14 (13%) cases and 6 (5.5%) cases died due to respiratory failure. Duration of hospital stay, mean time interval from toxic exposure to hospital presentation, leucocytosis, need for MV and cumulative dose of pralidoxime were significantly higher in non survivors than survivors while Pao2 (partial arterial oxygen) and GCS (Glasgow coma scale) were significantly lower.
CONCLUSION
This study concluded that time consumed till presentation to hospital, low GCS, need for MV, leucocytosis, decreased PaO2 and increased cumulative dose of pralidoxime were independent risk factors of mortality.
背景
有机磷是包括埃及在内的发展中国家最常见的中毒药物之一。由于缺乏有关我们当地有机磷中毒特征的数据，我们旨在评估其临床模式和影响结果的因素。
方法
这是一项在 2019 年 1 月至 2019 年 12 月期间在南谷大学医院进行的横断面研究。它包括所有因有机磷中毒而就诊的≤16 岁儿童。从患者亲属提供的病史和出现的症状进行诊断。评估了人口统计学数据、中毒方式和途径、暴露至就诊时间、临床症状、分级和常规检查，以及所采取的治疗方法和结果。
结果
在研究期间，有 108 名儿童（平均年龄为 7.95±4.11 岁[范围 1.5-16 岁]）出现有机磷中毒。65 例（60%）为女性，43 例（40%）为男性。意外（87%）行为比自杀（13%）更为常见，吸入途径（63.8%）比摄入途径（36.2%）更为常见。瞳孔缩小是最常见的临床症状（100%），其次是呼吸困难（77.7%）。关于到急诊就诊的时间，43 例（40%）在 6 小时内就诊，其余病例在暴露后 6 小时以上就诊。14 例（13%）需要机械通气（MV），6 例（5.5%）因呼吸衰竭死亡。非幸存者的住院时间、从中毒暴露到医院就诊的平均时间间隔、白细胞增多、需要 MV 和普洛肟累积剂量明显高于幸存者，而 PaO2（动脉血氧分压）和 GCS（格拉斯哥昏迷量表）明显低于幸存者。
结论
本研究表明，就诊时间、GCS 降低、需要 MV、白细胞增多、PaO2 降低和普洛肟累积剂量增加是死亡的独立危险因素。
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