發(fā)布時(shí)間：2018-03-27 13:47

  本文選題：天津市　切入點(diǎn)：急性中毒　出處：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的了解天津市急性中毒患者流行病學(xué)特征,了解天津市急診就診的急性中毒患者的現(xiàn)狀,為制訂針對性的預(yù)防措施和中毒后的急救方案提供科學(xué)指導(dǎo)。方法采用回顧性分析的方法,對2012年1月~2014年12月年天津市城鄉(xiāng)地區(qū)有中毒救治能力且病歷資料完整的7家三級醫(yī)院和3家二級醫(yī)院就診的急性中毒患者病例進(jìn)行整理,對天津市急性中毒患者3年間中毒人數(shù)變化、性別與年齡、診斷、患者來源、毒物種類及其季節(jié)分布特點(diǎn)、中毒原因、中毒途徑、首診治療及轉(zhuǎn)歸進(jìn)行分析。因一次中毒多次就診的患者只記錄一次。用SPSS 19.0統(tǒng)計(jì)軟件包進(jìn)行統(tǒng)計(jì)處理,計(jì)數(shù)資料使用百分比方式表示,組間比較和組內(nèi)比較均使用卡方檢驗(yàn)。結(jié)果該時(shí)間段共收集資料包括病例7964例。所有病例中,2012年就診人數(shù)3178人,2013年就診人數(shù)2800人,2014年就診人數(shù)1986人,急性中毒人數(shù)呈整體下降趨勢。納入統(tǒng)計(jì)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齡段為20~59歲(81.72%)。患者入院后根據(jù)臨床表現(xiàn)與病史做出臨床診斷的人數(shù)3679人,占46.2%,根據(jù)臨床表現(xiàn)與病史做出臨床診斷并完善毒理學(xué)證據(jù)的人數(shù)4285人,占53.8%。患者主要以城鎮(zhèn)居民(66.99%)為主。男性酒精中毒人數(shù)占第一位,有2685人,其次為藥物中毒,共682人;女性藥物中毒人數(shù)占第一位,共2150人,其次為酒精中毒,共745人。0~19歲、≥60歲中毒者以藥物中毒為主,20~59歲以酒精中毒人數(shù)最多。CO中毒主要發(fā)生在春冬季節(jié),農(nóng)藥中毒以夏秋季節(jié)為多。自殺是急性中毒的主要原因(66.89%)。消化道是最常見的中毒途徑(79.35%)。患者入院后,首診治療是洗胃的有4274人,占53.7%,使用特效解毒藥的有2333人,占29.3%,洗胃聯(lián)合特效解毒藥物的有335人,占4.2%,進(jìn)行血液凈化治療的有1022人,占12.8%。就診患者中好轉(zhuǎn)的有6740人,占84.6%,死亡的有79人,占1%,死亡患者主要是農(nóng)藥中毒60人(75.94%)和其他藥物中毒11人(13.92%),CO中毒和酒精中毒死亡人數(shù)較少,分別有5人(6.33%)和3人(3.80%)。失聯(lián)的有235人(3%),遺留后遺癥致自理能力下降等有910人(11.4%)。結(jié)論本文相對客觀的研究了天津市急性中毒的流行病學(xué)特征。急性中毒人數(shù)呈整體下降趨勢,中毒人群以具有勞動(dòng)能力的成年人為主,男性多于女性�；颊呷朐汉笾饕罁�(jù)臨床表現(xiàn)與病史做出臨床診斷。中毒患者以城鎮(zhèn)居民為主。毒物種類以酒精及藥物中毒為主,男性酒精中毒更為常見,女性藥物中毒的發(fā)生率較高。兒童及老年人藥物中毒較多,青壯年以酒精中毒為主。CO中毒主要發(fā)生在春冬季節(jié),農(nóng)藥中毒以夏秋季節(jié)為多。自殺是主要的中毒原因,自殺采取的方式最常見的藥物中毒和酒精中毒。中毒途徑主要是經(jīng)消化道�；颊呷朐汉�,主要給予洗胃、特效解毒藥及血液凈化等治療。急性中毒患者死亡的主要原因是農(nóng)藥中毒以及其他藥物中毒。
[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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R595;R181.3

【參考文獻(xiàn)】

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1 黎敏;李超乾;盧中秋;宋維;田英平;楊立山;張勁松;張新超;趙敏;趙曉東;y嚺，

本文編號：1671772