天津市急性中毒患者流行病学研究

发布时间：2018-03-27 13:47

本文选题：天津市　切入点：急性中毒　出处：《天津医科大学》2017年硕士论文

【摘要】：目的了解天津市急性中毒患者流行病学特征,了解天津市急诊就诊的急性中毒患者的现状,为制订针对性的预防措施和中毒后的急救方案提供科学指导。方法采用回顾性分析的方法,对2012年1月~2014年12月年天津市城乡地区有中毒救治能力且病历资料完整的7家三级医院和3家二级医院就诊的急性中毒患者病例进行整理,对天津市急性中毒患者3年间中毒人数变化、性别与年龄、诊断、患者来源、毒物种类及其季节分布特点、中毒原因、中毒途径、首诊治疗及转归进行分析。因一次中毒多次就诊的患者只记录一次。用SPSS 19.0统计软件包进行统计处理,计数资料使用百分比方式表示,组间比较和组内比较均使用卡方检验。结果该时间段共收集资料包括病例7964例。所有病例中,2012年就诊人数3178人,2013年就诊人数2800人,2014年就诊人数1986人,急性中毒人数呈整体下降趋势。纳入统计的病例中男性共有4159人,女性共有3805人,男女比例1.09:1,急性中毒患者的高峰年龄段为20~59岁(81.72%)。患者入院后根据临床表现与病史做出临床诊断的人数3679人,占46.2%,根据临床表现与病史做出临床诊断并完善毒理学证据的人数4285人,占53.8%。患者主要以城镇居民(66.99%)为主。男性酒精中毒人数占第一位,有2685人,其次为药物中毒,共682人;女性药物中毒人数占第一位,共2150人,其次为酒精中毒,共745人。0~19岁、≥60岁中毒者以药物中毒为主,20~59岁以酒精中毒人数最多。CO中毒主要发生在春冬季节,农药中毒以夏秋季节为多。自杀是急性中毒的主要原因(66.89%)。消化道是最常见的中毒途径(79.35%)。患者入院后,首诊治疗是洗胃的有4274人,占53.7%,使用特效解毒药的有2333人,占29.3%,洗胃联合特效解毒药物的有335人,占4.2%,进行血液净化治疗的有1022人,占12.8%。就诊患者中好转的有6740人,占84.6%,死亡的有79人,占1%,死亡患者主要是农药中毒60人(75.94%)和其他药物中毒11人(13.92%),CO中毒和酒精中毒死亡人数较少,分别有5人(6.33%)和3人(3.80%)。失联的有235人(3%),遗留后遗症致自理能力下降等有910人(11.4%)。结论本文相对客观的研究了天津市急性中毒的流行病学特征。急性中毒人数呈整体下降趋势,中毒人群以具有劳动能力的成年人为主,男性多于女性。患者入院后主要依据临床表现与病史做出临床诊断。中毒患者以城镇居民为主。毒物种类以酒精及药物中毒为主,男性酒精中毒更为常见,女性药物中毒的发生率较高。儿童及老年人药物中毒较多,青壮年以酒精中毒为主。CO中毒主要发生在春冬季节,农药中毒以夏秋季节为多。自杀是主要的中毒原因,自杀采取的方式最常见的药物中毒和酒精中毒。中毒途径主要是经消化道。患者入院后,主要给予洗胃、特效解毒药及血液净化等治疗。急性中毒患者死亡的主要原因是农药中毒以及其他药物中毒。
[Abstract]:Objective to investigate the epidemiological characteristics of acute poisoning patients in Tianjin and the present situation of acute poisoning patients in emergency department in Tianjin. To provide scientific guidance for the formulation of targeted preventive measures and emergency programmes after poisoning. From January 2012 to December 2014, acute poisoning cases were collected from 7 tertiary hospitals and 3 second-level hospitals in Tianjin, which had the ability to treat and treat poisoning in urban and rural areas and had complete medical records. Changes in the number, sex and age, diagnosis, patient origin, toxicant species and seasonal distribution characteristics, causes and ways of poisoning of acute poisoning patients in Tianjin during the past 3 years were studied. The first treatment and outcome were analyzed. The patients who had been visited many times because of a single poisoning were recorded only once. The statistics were processed by SPSS 19.0 statistical software package, and the counting data were expressed by percentage. Results data including 7964 cases were collected in this period. Among all the cases, there were 3178 patients in 2012, 2800 in 2013 and 1986 in 2014. The number of cases of acute poisoning showed an overall downward trend. There were 4159 men and 3805 women in the statistics. The ratio of male to female was 1.09: 1. The peak age of acute poisoning patients was 81.72 years old. 3679 patients were diagnosed according to their clinical manifestations and history. The number of patients who made clinical diagnosis and improved toxicological evidence according to their clinical manifestations and medical history was 4285, accounting for 53.88.The majority of the patients were urban residents (66.99g). The number of male alcoholism was the first (2685), followed by drug poisoning (682). The number of female drug poisoning was the first (2150), followed by alcohol poisoning (745) aged 19 years. Drug poisoning was the main cause of poisoning in women aged more than 60. Alcohol poisoning occurred mostly in spring and winter with the highest number of alcoholism in the age of 20 ~ 59 years old, and CO poisoning occurred mainly in the spring and winter seasons. The main cause of acute poisoning is suicide. Digestive tract is the most common way of poisoning. After admission, 4274 patients were treated with gastric lavage, accounting for 53.7%, 2333 of them used special antidote. 29.3 the number of patients with gastric lavage combined with special detoxification drugs was 335, accounting for 4.22.The blood purification treatment was carried out by 1022 people, accounting for 12.8.The number of patients who had seen a visit had improved by 6740, accounting for 84.6cm, and 79 people had died. The number of dead patients was mainly pesticide poisoning (60 people, 75.94) and other drugs poisoning (11 people, 13.92%). The number of deaths from CO poisoning and alcohol poisoning was relatively low. There were 5 persons (6.33) and 3 people (3.80%) respectively. 235 people were found to have lost contact with each other, and there were 910 people with decreased self-care ability caused by the sequelae. Conclusion the epidemiological characteristics of acute poisoning in Tianjin were studied objectively in this paper. The number of acute poisoning showed an overall downward trend. The patients were mainly diagnosed according to their clinical manifestations and history. The poisoning patients were mainly urban residents, and the types of poisons were mainly alcohol and drugs poisoning. Male alcoholism is more common, female drug poisoning rate is higher, children and the elderly drug poisoning is more, young adults mainly alcoholism. Co poisoning mainly occurs in spring and winter, Pesticide poisoning is more in the summer and autumn seasons. Suicide is the main cause of poisoning. The most common way to commit suicide is drug poisoning and alcohol poisoning. The main way of poisoning is through the digestive tract. The main causes of death in patients with acute poisoning are pesticide poisoning and other drug poisoning.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R595;R181.3

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