摘要
目的探索安徽阜阳地区急性磷化铝中毒的流行病学特征,为该类中毒制定相关的防治措施和法律法规提供理论依据,做好农村留守儿童及农民中毒防治工作.方法收集2011年1月至2018年12月阜阳市人民医院收治的158例急性磷化铝中毒患者的资料,对患者的来源、年龄、性别、文化程度、发病年份和月份、中毒原因、中毒途径和病死率等指标进行统计分析.结果158例患者主要来自于农村149例(94.3%),男女比例为1.14:1,各年龄段进行性别分析,差异无统计学意义(P>0.05).职业主要为农村留守中小学生和农民,共计143例(90.5%).患者文化教育程度较低,初中及以下文化程度为151例(95.6%),对患者各年龄段职业和学历进行分析,差异有统计学意义(P<0.05).中毒例数呈先上升后下降趋势,2016年患者例数达到最高峰,中毒例数为56例(35.4%),其中吸入性中毒47例,口服途径中毒9例,2017年中毒例数开始逐渐下降.中毒时间主要分布于6、7、8月份,为110例(69.5%),其中吸入性中毒89例(56.3%),口服中毒21例(13.2%).患者的主要中毒原因为意外中毒(104例),包括吸入性中毒96例,误服8例.中毒途径包括经呼吸道吸入96例(60.8%)和口服62例(39.2%).年龄<20岁患者98例(62.0%),其中意外中毒93例,经呼吸道吸入89例(56.3%);年龄≥20岁患者多为口服自杀(口服/自杀:53/49).对0~90岁9个年龄组的中毒原因和中毒途径分别进行比较,差异有统计学意义(P<0.05).患者的总病死率为15.2%(24/158),重度中毒的病死率高达72.7%,轻度中毒患者125例全部存活,两组病死率比较差异有统计学意义(P<0.05).口服中毒病死率高于吸入性中毒[25.8%(16/62)vs.8.3%(8/96),P<0.05].自杀因素导致的病死率高于意外中毒[29.6%(16/54)vs.7.7%(8/104),P<0.05].结论安徽阜阳地区急性磷化铝中毒患者主要来自农村,多为留守中小学生和农民,初中及以下文化程度比例较高,男性略多于女性.青少年和儿童中毒主要以意外导致的吸入性中毒为主.成年患者主要以口服自杀中毒为主.中毒例数呈先上升后下降趋势,2016年达到峰值后再逐渐下降.中毒发生呈季节密集性,主要集中在6、7和8月份,尤其7和8月份.积极做好该类中毒人群的科普和文化宣传以及防治工作,尤其针对留守儿童的宣教和监护,有助于降低急性磷化铝中毒的发生率和病死率.
Objective To explore the cpidemiological characterstics of acute aluminum phosphide poisoning in Fuyang area,in order to provide theoretical basis for the establishment of related prevention and control measures,laws and regulations.Methods From January 2011 to December 2018,158 patients with acute aluminum phosphide poisoning treated in Fuyang People's Hospital were collected,and the source,age,sex,education level,year and month of onset,etiology,poisoning pathway and mortality of the patients were statistically analyzed.Results 158 patients were mainly from rural areas(149,94.3%),the ratio of men to women was 1.41:1,and there were no statistically signifieant differences in the gender analysis(P>0.05).The main occupation was rural left-behind primary and secondary school students and farmers,a total of 143 cases(90.5%).Patients received a lower level of cultural education,and the proportion of junior high school and below education level was higher(151,95.6%).The analysis of occupational and academie qualfications in the patients of all ages was statistically significant(P<0.05).The number of patients reached its highest peak in 2016,with 56 cases of poisoning(35.4%),including 47 cases of inhalation poisoning,which exceeded those of oral route poisoning(9 cases),and the number of poisonings began to gradually decline in 2017.The time of onset was mainly distributed in June,July and August,with 110 cases(69.5%),of which 89 were inhalation poisoning(56.3%)and 21 were oral poisoning(13.2%).The main cause was accidental poisoning(104 cases),including 96 cases of inhalation poisoning and 8 cases of accidental administration.Poisoning route included inhalation poisoning(92,60.8%)and oral poisoning(62,39.2%)98 cases(62.0%)were under 20 years old,ineluding 93 cases of accidental poisoning and 89 cases(56.3%)of respiratory tract absorption.Most of the patients aged 20 and over committed oral suicide(oral/suicide:53/49).The etiology and poisoning route of 9 age groups aged 0 to 90 years old were compared,and there were significant diferences between the groups(P<0.05).Case fatality rate was 15.2%(24/158),the case fatality rate of severe poisoning was as high as 72.7%,125 cases of mild poisoning all survived,there were statistically significant differences in the case fatality rate between the two groups(P<0.05).Case fatality rate of oral poisoning was higher than that of inhalation poisoning[25.8%(16/62)vs.8.3%(8/96),P<0.05].Mortality due to suicide factors was higher than that of accidental poisoning[29.6%(16/54)vs.7.7%(8/104),P<0.05].Conclusion Patients with acute aluminum phosphide poisoning mainly come from rural areas,most of them are left-behind primary and middle school students and farmers,the proportion of middle school and below education level is higher,and men are slightly more than women.The incidence of young people and children are mainly caused by accidental inhalation poisoning.The main adult patients are oral suicide poisoning.The incidence of the disease increased year by year,and then gradully decreased after reaching its peak in 2016.Poisoning is seasonally dense,mainly in June,July and August,especially in July and August.It is helpful to reducee the incidence and fatality of acute aluminum phosphide poisoning by doing a good job of popularizing science and cultural propaganda and preventing and treating such poisoning,especially for children left behind.
作者
杨一红
张泓
Yang Yi-hong;Zhang Hong(Department of Emergency Medicine,First Aflited Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中国急救医学》
CAS
CSCD
北大核心
2020年第7期678-682,共5页
Chinese Journal of Critical Care Medicine
基金
安徽省阜阳市临床重点学科建设项目(卫科教[2017]29号)。
关键词
磷化铝
中毒
流行病学
研究
Aluminum phosphide(ALP)
Poisoning
Epidemiology
Survey
