家庭清洁产品中毒在儿科急诊中心：一项 10 年的横断面研究及文献复习。

Household cleaning products poisoning in a pediatric emergency center: A 10- year cross-sectional study and literature review.

机构信息

Division of Nephrology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.

出版信息

Pediatr Neonatol. 2021 Nov;62(6):638-646. doi: 10.1016/j.pedneo.2021.05.026. Epub 2021 Jul 16.

DOI:10.1016/j.pedneo.2021.05.026

PMID:34332912

Abstract

BACKGROUND

Poisoning by household cleaning products(HCPs) is common in children. Some HCPs are toxic and may cause severe complications. We assessed HCP poisonings treated in a pediatric emergency department(PED).

METHODS

This was a retrospective study of patients aged under 18 years with HCP poisoning admitted to the largest PED in Taiwan from 2011 to 2020 were recruited.

RESULTS

The records over a 10-year period from 103 children admitted to the PED because of HCP poisoning(70 boys [68%] and 33 girls [32%]), mean age 3.54 years(standard deviation [SD] = 3.15 years) were evaluated. Most poisonings were unintentional(99%, n = 102) and occurred at home(96%, n = 99). The HCPs included alkaline(74%, n = 76), acidic(25%, n = 26), and neutral(1%, n = 1) agents. Most were orally ingested(86%, n = 89). Panendoscopy was performed in 25 patients(24%), and the endoscopic(Zargar) grade was used to determine the severity of injury. Medications(steroids [9%, n = 9], antibiotics [10%, n = 10], or antacids [30%, n = 23]) were prescribed. Alkaline HCP ingestion induced severe esophageal injury(p = 0.04) and esophageal stricture(p = 0.04). Five patients(5%) exhibited esophageal strictures and required balloon dilation. On multivariate analysis, alkaline HCP ingestion(p = 0.04), severe esophageal caustic injury(Zargar grade ≥ 3) (p < 0.001), and medications(steroids [p < 0.001], antibiotics [p < 0.001], and antacids [p = 0.001]) were associated with esophageal stricture.

CONCLUSION

Alkaline HCP ingestion and severe esophageal caustic injury(Zargar grade ≥ 3) were associated with esophageal stricture. Physicians tended to prescribe medications(steroids, antibiotics, or antacids) for patients with severe esophageal injuries to reduce the risk of esophageal stricture. The usefulness of these medications requires further study.

摘要

背景

家用清洁产品（HCP）中毒在儿童中很常见。一些 HCP 具有毒性，可能会导致严重的并发症。我们评估了在台湾最大的儿科急诊部（PED）治疗的 HCP 中毒患者。

方法

这是一项回顾性研究，纳入了 2011 年至 2020 年期间因 HCP 中毒而入住台湾最大 PED 的 103 名 18 岁以下儿童患者的记录。

结果

共评估了 103 名因 HCP 中毒而入住 PED 的儿童患者（70 名男孩[68%]和 33 名女孩[32%]），平均年龄 3.54 岁（标准差[SD]=3.15 岁）。大多数中毒是无意的（99%，n=102），发生在家庭中（96%，n=99）。HCP 包括碱性（74%，n=76）、酸性（25%，n=26）和中性（1%，n=1）制剂。大多数是经口摄入（86%，n=89）。25 名患者（24%）进行了全内镜检查（Panendoscopy），使用内镜（Zargar）评分来确定损伤的严重程度。给予药物治疗（皮质类固醇[9%，n=9]、抗生素[10%，n=10]或抗酸剂[30%，n=23]）。碱性 HCP 摄入导致严重的食管损伤（p=0.04）和食管狭窄（p=0.04）。5 名患者（5%）出现食管狭窄，需要球囊扩张。多变量分析显示，碱性 HCP 摄入（p=0.04）、严重的食管腐蚀性损伤（Zargar 分级≥3）（p<0.001）和药物治疗（皮质类固醇[p<0.001]、抗生素[p<0.001]和抗酸剂[p=0.001]）与食管狭窄相关。