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探讨中毒药物与药物中毒儿童临床特征之间的关系:一项在三级转诊医院开展的横断面研究。

Investigating the relationship between the intoxicated drug and clinical profile of children with drug poisoning: a cross-sectional study in a tertiary referral hospital.

作者信息

Rezazadeh Mohammad, Fares Forozan, Rasulpour Farhad, Kachuei Maryam, Kheradpishe Ahmadreza, Joghataei Mohammad Taghi, Zareh Ramin, Fathaliyan Youssef

机构信息

Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Department of Forensic Medicine, Iran University of Medical Science, Tehran, Iran.

出版信息

Ann Med Surg (Lond). 2025 Apr 29;87(6):3171-3177. doi: 10.1097/MS9.0000000000003306. eCollection 2025 Jun.

Abstract

BACKGROUND

Pediatric drug poisoning is a significant public health concern, with opioids being the most common agents in poisoning cases. Despite its importance, limited data are available on the relationship between clinical presentations, laboratory findings, and the age of affected children.

OBJECTIVES

This study aimed to evaluate the clinical and laboratory profiles of pediatric drug poisoning cases and to assess age-related variations in symptoms and laboratory markers.

METHODS

A retrospective analytical cross-sectional study was conducted in the emergency department, from April to October 2023. The study included 82 children aged below 12 years with positive toxicology tests. Demographic data, clinical symptoms (lethargy, seizures, respiratory and gastrointestinal symptoms), and laboratory findings (pH, HCO, base excess [BE], PCO, and heart rate) were analyzed using SPSS version 27. Statistical significance was set at < 0.05.

RESULTS

Methadone (48.8%) was the most common substance involved in poisoning, and lethargy (89.0%) was the most prevalent symptom. Respiratory symptoms were more common in younger children ( < 0.001), while lethargy was more frequent in older children ( = 0.032). Laboratory findings indicated metabolic acidosis with reduced pH (7.24 ± 0.15), BE (-8.13 ± 6.0), and HCO (19.3 ± 4.5). Tachycardia was observed in most cases (116.6 ± 26.1 bpm).

CONCLUSION

Pediatric drug poisoning, particularly methadone poisoning, poses significant risks, with lethargy and respiratory symptoms being prominent age-related presentations. Metabolic acidosis emerges as a key diagnostic marker. These findings underscore the importance of early recognition, targeted interventions, and prevention strategies, including safe medication storage and caregiver education.

摘要

背景

儿童药物中毒是一个重大的公共卫生问题,阿片类药物是中毒病例中最常见的药物。尽管其重要性,但关于临床表现、实验室检查结果与受影响儿童年龄之间的关系的数据有限。

目的

本研究旨在评估儿童药物中毒病例的临床和实验室特征,并评估症状和实验室指标的年龄相关差异。

方法

于2023年4月至10月在急诊科进行了一项回顾性分析横断面研究。该研究纳入了82名12岁以下毒理学检测呈阳性的儿童。使用SPSS 27版分析人口统计学数据、临床症状(嗜睡、惊厥、呼吸和胃肠道症状)以及实验室检查结果(pH值、碳酸氢根、碱剩余[BE]、二氧化碳分压和心率)。统计学显著性设定为<0.05。

结果

美沙酮(48.8%)是中毒涉及的最常见物质,嗜睡(89.0%)是最普遍的症状。呼吸症状在年幼儿童中更常见(<0.001),而嗜睡在年长儿童中更频繁(=0.032)。实验室检查结果显示代谢性酸中毒,pH值降低(7.24±0.15),BE(-8.13±6.0),碳酸氢根(19.3±4.5)。大多数病例观察到心动过速(116.6±26.1次/分钟)。

结论

儿童药物中毒,尤其是美沙酮中毒,构成重大风险,嗜睡和呼吸症状是突出的年龄相关表现。代谢性酸中毒成为关键的诊断标志物。这些发现强调了早期识别、针对性干预和预防策略的重要性,包括安全储存药物和对照顾者进行教育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67f4/12140741/6301d4fecb15/ms9-87-3171-g001.jpg

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