摘要
目的分析儿童毒蕈中毒流行病学特点、临床特征及血液净化疗效。方法对2002至2020年入住湖南省儿童医院的51例急性毒蕈中毒患儿的临床资料进行回顾性研究,分析其流行病学特点及临床特征,对不同潜伏期患儿预后进行比较,并对其中给予血液净化治疗的36例危重症患儿进行疗效分析。结果51例急性毒蕈中毒患儿的年龄分布为66(43,115)个月;毒蕈中毒有明显的季节性和空间聚集性。首发症状以消化道表现为主,表现为呕吐、腹痛、腹泻(94.1%,48/51)。临床分型中胃肠道型45.1%(23/51),多器官损害型51.0%(26/51)。住院时间6(3,11)d。其中早发型45.1%(23/51),晚发型54.9%(28/51),早发型住院时间4(2,7)d,损伤器官数目1(0,3)个,晚发型住院时间8(3,12)d,损伤器官数目为4(2,4)个,差异有统计学意义(P<0.05)。晚发型患儿器官功能损伤更严重,主要表现在肝功能、凝血功能、肾功能、心肌酶,两组间好转率差异无统计学意义。给予血液净化治疗的36例患儿,丙氨酸转氨酶、天冬氨酸转移酶、凝血酶原时间、国际标准化比值、尿素氮、乳酸脱氢酶均有明显改善,差异有统计学意义(P<0.05)。结论毒蕈中毒有明显的季节性与地域分布特点;首发表现以消化道症状为主;临床分型以胃肠道型及多器官损害型多见。早发型较晚发型患儿住院时间更短、并发症更少,血液净化治疗对毒蕈中毒患儿的肝功能、肾功能及凝血功能均有明显改善。
Objective To analyze the epidemiological characteristics,clinical characteristics and blood purification effect of mushroom poisoning in children.Methods A retrospective study was conducted on 51 children with acute mushroom poisoning admitted to Hunan Children′s Hospital from 2002 to 2020.The epidemiological and clinical characteristics were analyzed,and the prognosis of children with different incubation periods was analyzed and compared.Among them,36 critically ill children were treated with blood purification.Results The age distribution was 66(43,115)months.Mushroom poisoning had obvious seasonal and spatial aggregation.The first symptom was mainly manifested by digestive tract,which was manifested as vomiting,abdominal pain and diarrhea,accounting for 94.1%patients(48/51).The gastrointestinal tract type accounted for 45.1%(23/51)of the clinical types and the multi-organ damage type accounted for 51.0%patients(26/51).The length of hospital stay was 6(3,11)days.Among them,early onset accounted for 45.1%patients(23/51),late onset accounted for 54.9%patients(28/51).Early onset hospitalization was shorter,about 4(2,7)days,and fewer organs 1(0,3)were damaged.The length of hospital stay of late onset was 8(3,12)days,and the number of damaged organs was 4(2,4).There was a statistically significant difference(P<0.05).Late onset patients had more severe organ function damage,including liver function,coagulation function,renal function,myocardial enzyme,and there was no significant difference in the final outcome between two groups.In 36 children who were given blood purification treatment,alanine aminotransferase,aspartate aminotransferase,prothrombin time,international normalized ratio,blood urea nitrogen,and lactate dehydrogenase were significantly improved,with statistically significant differences(P<0.05).Conclusion Mushroom poisoning has obvious seasonal and geographical distribution characteristics;the first manifestation is mainly gastrointestinal symptoms;the clinical types are more common in gastrointestinal and multiple organ damage types.Children with early onset have shorter hospital stays and fewer complications than later onset.Blood purification treatment can significantly improve liver function,kidney function and blood coagulation function in children with toadstool poisoning.
作者
龚玲
卢秀兰
肖政辉
颜海鹏
Gong Ling;Lu Xiulan;Xiao Zhenghui;Yan Haipeng(Emergency Center,Hunan Children′s Hospital,Changsha 410007,China)
出处
《中国小儿急救医学》
CAS
2021年第9期763-768,共6页
Chinese Pediatric Emergency Medicine
基金
儿童急救医学湖南省重点实验室项目(2018TP1028)
湖南省重点研发项目(2020SK2114)。
关键词
毒蕈中毒
儿童
临床特征
潜伏期
血液净化
Mushroom poisoning
Children
Clinical features
Incubation period
Blood purification
