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急性藥物中毒256例臨床特點與診治分析
Clinical analysis of clinical features, diagnosis and treatment of 256 cases of acute drug poisoning
摘要
目的：回顧與分析澳門鏡湖醫院急診科就診的藥物中毒患者的臨床特點和救治策略，為急性藥物中毒的進一步防治提供科學依據。方法：2007年1月～2011年12月間到本院急診科就診的藥物中毒個案共256例，根據性別、年齡、中毒物質、中毒原因和診斷治療方法進行統計和分析。結果：本組患者共256例，男女比為1:2.66，年齡集中在18歲～40歲區間，各年份就診人數未見明顯差別。中毒物質常見的是鎮靜催眠劑156例（60.9%）、毒品31例（12.1%）、解熱鎮痛劑31例（12.1%）。自殺、濫藥與吸毒、誤服是主要的中毒原因。自殺患者中男女比例為1:3.56，18歲～40歲年齡段自殺人數比例最多。藥物測試方法診斷中，尿毒物測試陽性65例，陰性144例，Paracetamol濃度測試完成25例，3例達到藥物中毒濃度。臨床治療上使用活性炭吸附毒物共176例，佔總人數68.8%；機械洗胃的病人33例（佔12.89%），催吐100例（佔39.06%）；輸液支持治療的228人（佔89.1%）；使用解毒劑39人（佔15.2%）。急診觀察治療後好轉離院的236例（佔92.19%），住院16例（佔6.25%），轉院4例（佔1.56%），死亡2例（佔0.78%）。結論：本研究提供了澳門地區急診藥物中毒特點的基本資料，為急性藥物中毒防治提供最新的流行病學資料。
並列摘要
Objective: To review and analyze the clinical features ,diagnosis and treatment among the patients with drug poisoning in A&E department of Kiang Wu hospital of Macau in order to provide evidence for further successful rescue and prevention of acute drug poisoning. Methods: Total 256 cases with drug poisoning were collected from January 2007 to December 2011 in A&E department of Kiang Wu hospital All the patients were statistically analyzed according to sex, age, cause, toxicant, diagnosis and treatment. Results: Among 256 cases male to female ratio was 1:2.66. Age concentrated in the range of 18-40 years. No significant difference in the number of patient in these few years . Sedative and hypnotic agents, narcotics and antipyretic analgesics were the most common toxicants. 156 cases (60.9%)of sedative and hypnotic agent poisoning, 31 cases (12.1%) of narcotics, 31 cases (12.1%) of antipyretic analgesics. Suicide, drug abuse, ingestion were the main cause of drug poisoning. Male to female ratio in suicide group was 1:3.56. The largest proportion of 18-40 year-old age group was suicide. There were 65 positive cases and 144 negative cases when performing drug test urine. The concentration of paracetamol was tested in 25 cases, 3 cases reached poisoning concentration. Total 176 cases (68.8%)were treated with activated charcoal for adsorption poison; 33 cases (12.89%) were treated with gastric lavage, 100 cases(39.06%) were treated with emetic; Supportive treatment was supplied in 228 cases (89.1%), 39 cases were treated with antidotes (15.2%), 236 cases (93.75%) got improved from hospital emergency observation and treatment. 16 cases (6.25%)needed hospitalization, 4 cases (1.56%) were transferred to government hospital, 2 cases died (0.78%) after transferred. Conclusion: This study provided some basic information of emergency drug toxicity some latest epidemiological information and evidence for the prevention and treatment of acute drug poisoning in Macau.