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三级护理医院中毒病例的临床特征分析与评估研究

Study of the Clinical Profiling and Assessment of Poisoning Cases in a Tertiary Care Hospital.

作者信息

Patil Abhishek, Kasture Ameya A, Pathak Prasad, Patil Shweta, Chavan Sushant S

机构信息

Medicine, Shri Bhausaheb Hire Government Medical College and Hospital, Dhule, IND.

Community Medicine, Shri Bhausaheb Hire Government Medical College and Hospital, Dhule, IND.

出版信息

Cureus. 2024 Aug 15;16(8):e66934. doi: 10.7759/cureus.66934. eCollection 2024 Aug.

Abstract

Introduction Accidental and intentional poisoning is a major cause of morbidity and mortality. Pesticide poisoning is particularly common in India, where a large percentage of the population works in agriculture. This study aims to evaluate admission profiles, management trends, and outcome status among poisoning cases in a tertiary care hospital. Methodology A prospective observational study was carried out from May to July 2022 in the medicine ward of a tertiary care hospital, which is associated with a government medical college. Demographic characteristics, history of poisoning, clinical presentation at the time of admission, and intervention for treatment were recorded once the patient was diagnosed with poisoning or when there was a suspicion. Data regarding outcomes was also collected from this section. The appropriateness of the decontamination, support, and specific treatments was assessed. The collected data was subjected to descriptive statistical analysis. Results The most common agent was pesticides, involved in 44 (43.56%) cases out of a total of 101 poisoning cases, with the predominant subtype being organophosphate. Bites accounted for 18 (17.82%) cases, mainly snake bites. Household products were responsible for eight (7.92%) cases, and medicinal products for four (3.96%) cases. Decontamination, when indicated, was properly applied in 98 (97.02%) cases; supportive treatments were administered in 95 (94.05%) cases; and specific detoxifying measures were taken in 59 (58.41%) cases. A majority of the patients (60, or 59.41%) reached the hospital within three hours of poisoning, which dramatically reduced morbidity and mortality. Conclusion In summary, the study indicates that pesticide poisoning is prevalent in rural India, and, as such, there is an urgent need for appropriate regulation of agrochemicals and behavioural education to protect farmers. On average, the appropriateness of decontamination and supportive treatments was high (i.e., >85%), reflecting adequate initial responses. In contrast, the low level of appropriateness for specific treatments highlights gaps regarding institutional medical protocols and training. There is a need to educate the public about timely medical intervention, which can help in decreasing the mortality and morbidity associated with cases of poisoning.

摘要

引言

意外中毒和故意中毒是发病和死亡的主要原因。农药中毒在印度尤为常见,该国很大一部分人口从事农业工作。本研究旨在评估一家三级护理医院中毒病例的入院情况、管理趋势和预后状况。

方法

2022年5月至7月,在一所与政府医学院相关的三级护理医院的内科病房进行了一项前瞻性观察研究。一旦患者被诊断为中毒或存在中毒嫌疑,就记录其人口统计学特征、中毒史、入院时的临床表现以及治疗干预措施。还从这部分收集了有关预后的数据。评估了去污、支持治疗和特效治疗的适宜性。对收集到的数据进行描述性统计分析。

结果

最常见的中毒剂是农药,在总共101例中毒病例中有44例(43.56%)涉及农药,其中主要亚型为有机磷。咬伤占18例(17.82%),主要是蛇咬伤。家用产品导致8例(7.92%)中毒,药品导致4例(3.96%)中毒。在有指征时,98例(97.02%)病例正确进行了去污;95例(94.05%)病例给予了支持治疗;59例(58.41%)病例采取了特效解毒措施。大多数患者(60例,占59.41%)在中毒后三小时内到达医院,这显著降低了发病率和死亡率。

结论

总之,该研究表明农药中毒在印度农村地区很普遍,因此迫切需要对农用化学品进行适当监管并开展行为教育以保护农民。平均而言,去污和支持治疗的适宜性较高(即>85%),反映出初步反应充分。相比之下,特效治疗的适宜性较低,凸显了机构医疗方案和培训方面的差距。有必要对公众进行及时医疗干预的教育,这有助于降低与中毒病例相关的死亡率和发病率。

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