Siwach S B, Gupta A
Department of Medicine, Medical College, Rohtak.
J Assoc Physicians India. 1995 Nov;43(11):756-9.
A prospective study of 559 cases of acute poisoning who came to this hospital over a period of 14 months. 91.4% cases were of self poisoning (suicidal), 8.1% accidental and only 0.5% homicidal. Majority of patients were young (mean age 27 years), males twice the number of females. Almost 3/4th of the total patients belonged to lower socio-economic group (rural more than urban). The common causative factors which led to self poisoning were marital disharmony, economic hardships and scolding/disagreement with other family members. Aluminium phosphide (ALP) was the most commonly abused substance followed by organophosphates and zinc phosphide in 67.8, 13.9 and 4.3% cases respectively. The overall mortality rate in the series was 33.82%, but true mortality rate in patients who consumed ALP was as high as 67.6%. Most of these cases (94.9%) were not given any preliminary treatment in the village primary health centre (PHC) nearest to the site of mishap and they were brought/referred to this hospital straight and thus most valuable time crucial for effective treatment was lost. Easy availability of a highly toxic substance like ALP at peak moments of frustration has added fuel to the fire and pushed up the incidence of self-poisoning. Suggested preventive measures include caging of tablets in plastic packs, stringent restrictions on free supply of ALP and education of medical/paramedical personnel involved in health care delivery at grass root level.
对14个月内前来本院就诊的559例急性中毒病例进行的前瞻性研究。91.4%的病例为自我中毒（自杀性），8.1%为意外中毒，仅有0.5%为他杀中毒。大多数患者较为年轻（平均年龄27岁），男性数量是女性的两倍。几乎四分之三的患者属于社会经济地位较低的群体（农村地区多于城市地区）。导致自我中毒的常见因素包括婚姻不和、经济困难以及与其他家庭成员的争吵/意见不合。磷化铝（ALP）是最常被滥用的物质，其次是有机磷和磷化锌，分别占病例的67.8%、13.9%和4.3%。该系列的总体死亡率为33.82%，但服用ALP患者的实际死亡率高达67.6%。这些病例中的大多数（94.9%）在事故发生地附近的乡村初级卫生保健中心（PHC）未接受任何初步治疗，而是直接被送往/转至本院，因此失去了有效治疗至关重要的最宝贵时间。在极度沮丧的高峰期，像ALP这样的剧毒物质容易获取，这无疑是火上浇油，推高了自我中毒的发生率。建议的预防措施包括将片剂装在塑料包装中密封、严格限制ALP的自由供应以及对基层医疗保健服务中的医疗/辅助医疗人员进行教育。
