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儿科重症急性中毒患者的人口学和临床特征评估:中国吉林省的一项单中心研究。

Demographics and Clinical Characteristics Assessment of Severe Acute Toxic Ingestions in Pediatric Patients: A Single-Center Study in Jilin Province of China.

机构信息

From the Pediatric Critical Care, Department of Pediatric Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin, China.

Pediatric Rehabilitation, Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Pediatr Emerg Care. 2023 Dec 1;39(12):957-962. doi: 10.1097/PEC.0000000000003077.

Abstract

OBJECTIVE

This study aimed to describe the demographic and clinical characteristics of severe acute toxic ingestions in children in Jilin Province and provide a reference for seeking effective measures to prevent poisoning accidents.

METHODS

The clinical data of patients diagnosed with acute toxic ingestions and who presented with severe life-threatening symptoms or organ dysfunction at the Pediatric Intensive Care Unit of the First Hospital of Jilin University were retrospectively analyzed. Patients with incomplete clinical medical records, unclear toxic substance, and loss to follow-up within 6 months of discharge are excluded. We sorted out these children's demographic characteristics, types of poisoning, clinical manifestations, treatment process, and follow-up, etc.

RESULTS

This study enrolled 141 cases with no significant differences in sex and region; adolescents accounted for 44.68%. The most common poisons were pesticides and insecticides for rural areas and internal medication for urban areas. With poisoning details as a grouping variable, there was no statistical difference between sex groupings (χ2 = 6.018, P = 0.198) and no difference between region groups (χ2 = 3.775, P = 0.289). However, there were statistical differences between age groups (χ2 = 28.22, P = 0.001). In this research, patients younger than 6 years are mainly unintentionally poisoned, whereas the suicide rate of the urban group (P < 0.05), adolescents (P < 0.01), and girls (P < 0.01) has increased significantly; moreover, the suicide group is more likely to take more overdose medication or pesticides and insecticides (P < 0.01). In addition, there was a statistical difference between suicide and length of intensive care unit stay (r = 0.268, P < 0.01). A total of 90.78% of the patients were successfully discharged after comprehensive treatment. Children aged younger than 12 years had good psychological and intellectual development during the follow-up period, whereas adolescents diagnosed with depression often required long-term psychological and medication intervention.

CONCLUSIONS

This study identified poisoning details in different ages, regions, and sex of acute severe oral poisoning in children from Jilin Province. The results presentation of different prevention priorities should vary among children of different ages and emphasize adolescent suicide being a reality in Jilin Province. There is an urgent need for further culture-specific research in this area.

摘要

目的

本研究旨在描述吉林省儿童严重急性中毒的人口统计学和临床特征,并为寻找预防中毒事故的有效措施提供参考。

方法

回顾性分析吉林大学第一医院儿科重症监护病房收治的急性中毒患者的临床资料,这些患者具有严重的生命威胁症状或器官功能障碍。排除临床病历资料不完整、中毒物质不明确以及出院后 6 个月内失访的患者。我们整理了这些儿童的人口统计学特征、中毒类型、临床表现、治疗过程和随访等信息。

结果

本研究共纳入 141 例患者,在性别和地区方面无显著差异;青少年占 44.68%。最常见的毒物是农村地区的农药和杀虫剂,城市地区的则是内服药。以中毒细节为分组变量,性别分组之间无统计学差异(χ2=6.018,P=0.198),地区分组之间也无差异(χ2=3.775,P=0.289)。然而,年龄组之间存在统计学差异(χ2=28.22,P=0.001)。在本研究中,6 岁以下的患者主要是意外中毒,而城市组(P<0.05)、青少年(P<0.01)和女孩(P<0.01)的自杀率显著增加;此外,自杀组更有可能服用过量的药物或农药和杀虫剂(P<0.01)。此外,自杀和重症监护病房住院时间之间存在统计学差异(r=0.268,P<0.01)。经过综合治疗,90.78%的患者成功出院。在随访期间,年龄小于 12 岁的儿童心理和智力发育良好,而被诊断为抑郁症的青少年则经常需要长期的心理和药物干预。

结论

本研究确定了吉林省不同年龄、地区和性别的儿童急性重度口服中毒的中毒细节。不同年龄儿童的预防重点结果呈现不同,强调了青少年自杀在吉林省是一个现实问题。这方面迫切需要进一步的特定文化研究。

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