47例自服百草枯中毒患儿病例分析

目的:通过分析47 例儿童自服百草枯中毒病例的特征、治疗情况及预后,为防治儿童百草枯中毒措施的制定提供参考。 方法:回顾性分析某三甲儿童医院自2012年1月至2017年1月自服百草枯中毒患儿的临床资料,分析其人口学特征、临床特征、影响预后的因素以及随访生存情况。结果:自服患儿男29例,女18例,年龄(12.3±1.7)岁。所有患儿均来自农业种植地区,留守儿童占比42.6%(20/47)。百草枯均为浓度20%的水剂,服药量10(5,20)mL。34例患儿出现肺、肾、肝、心等两个以上器官损害。服药7 d后26例患者出现呼吸困难。病死率48.9%(23/47),死亡时间分布在中毒后30 d内,早期病死率高。将病例资料分为存活组、死亡组,与死亡组相比,存活组患儿服药量少、就医时间短(P<0.01)。结论:儿童自服百草枯以青少年为主,具有服药量大、致死率高的特点。急性百草枯中毒缺乏特效解毒药物,应采取综合治疗措施,中毒后早期的医疗干预尤为重要。

Intentional Paraquat Poisoning in 47 Children

Objective: To analyze the characteristics, treatment and prognosis of paraquat poisoning intoxication in 47 children, so as to provide data for the formulation of measures for the prevention and treatment of paraquat poisoning in children. Methods: The clinical data of children with paraquat poisoning admitted to a Grade III Level A hospital from Jan. 2012 to Jan. 2017 were retrospectively reviewed, and the demographic characteristics, clinical characteristics, prognostic factors, and follow-up survival were analyzed.Results: There were 18 males and 29 females, with an average age of (12.3±1.7) years. All children were from agricultural planting areas, and the proportion of left-behind children was 42.6% (20/47). Paraquat was the 20% aqueous agent with the dosage of 10 (5,20) mL. There were 34 cases developed lung, kidney, liver and heart damage. After 7 d of medication, 26 cases developed dyspnea.The mortality rate was 48.9% (23/47), and the death time was distributed within 30 d after poisoning. The early mortality rate was high. The case data were divided into survival group and death group. Compared with the death group, the survival group had less medication and shorter medical treatment time (P<0.01). Conclusion: The majority of intentional paraquat are adolescents, with the characteristics of large dose and high mortality. In acute paraquat poisoning, there is a lack of effective detoxification drugs, so comprehensive treatment measures should be taken. Early medical intervention after poisoning is particularly essential.