三级医院中毒儿童的临床概况和治疗结果研究

Chirag D. Shah, Aditi Kaple, Kankana Pratihar, Kush Patel, Jhalak Patel
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摘要

背景:中毒是一种常见的儿科急症。据估计,全世界 20 岁以下儿童的中毒率为每 10 万人口中有 1.8 人中毒,而印度的中毒率为 0.6%至 11.6%:研究在艾哈迈达巴德 B. J. 医学院和艾哈迈达巴德平民医院进行。这是一项前瞻性分析研究,共有 110 名患者在 2018 年 6 月至 2018 年 11 月期间入住重症监护室,纳入标准为年龄小于 12 岁的儿童,有食用有毒物质/昆虫叮咬史,无论症状和体征如何,但不包括食物中毒和特异性药物反应病例。在征得家长的必要同意后,填写了详细的表格。无论中毒类型或途径如何,都要进行常规调查并采集胃液样本进行法医分析。必要时进行特殊检查。结果分析采用秩方:最常见的年龄组为 3-6 岁,男女比例为 1.5:1。99.1%的中毒是意外事故,其中最常见的是碳氢化合物中毒(27.2%),其次是家庭用品中毒(20.9%)。蛇咬伤是最常见的昆虫咬伤(10.9%)。平均住院时间为 3.9 天,8.1% 的儿童死亡,其中中毒 6 小时后就诊的儿童死亡率最高:中毒处理需要立即提供建议和急救,然后进行指导性治疗。净化、强化消除、解毒剂和支持性护理是处理中毒病例的常用方法。
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Study of clinical profile and outcome of children presented with poisoning in tertiary care hospital
Background: Poisoning is a common paediatric emergency. Worldwide estimate suggests that the rate of poisoning in under 20 years is 1.8 per one lakh population and for India it ranges between 0.6 to 11.6%. Methods: The study was conducted at B. J. Medical College Ahmedabad and Civil Hospital, Ahmedabad. A prospective analytical study consisting of total 110 patients, admitted in the intensive care unit during the period from June 2018 to November 2018 with inclusion criterion of children <12 years of age, presented with history of consumption of poisonous substances/insect bite irrespective of signs and symptoms excluding cases of food poisoning and idiosyncratic drug reactions. Detailed proforma was filled after taking necessary consent from the parents. Routine investigations and gastric samples for forensic analysis were sent in all irrespective of type or route of poisoning. Specific investigations done wherever required. Analysis of outcomes done using chi square. Results: The most common age group was 3-6 years with male to female ratio of 1.5:1. 99.1% poisoning were accidental with hydrocarbon poisoning being the most common of all (27.2%), followed by household substance poisoning in 20.9%. Snakebite was the most common insect bite (10.9%). The average duration of stay was 3.9 days, 8.1% children died with maximum mortality happened in children presented after 6 hours of intoxication. Conclusions: Management of poisoning requires immediate advice and first aid, followed by a directed treatment. Decontamination, enhanced elimination, antidotes, and supportive care are commonly used to manage poisoning cases.
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