10Years Clinical Retrospective Ananlysis In Children Of Acute Poisoning Inpatient

Acute poisoning is a common critical and emergency disease in children. Clinical features in children with acute poisoning are different from the adult relatively, since childhood is the special life stage with continuous growth. Bee sting is part of Pediatric acute poisonings. Serious bee stings often have clinical manifestations and poor prognosis. This present study includes the following two parts:Part Ⅰ10years clinical retrospective analysis in children of acute poisoning inpatientObjective:To investigate the clinical features, the change rules, treatments and the outcomes of acute pediatric poisonings children admitted to the children’s hospital of Chongqing medical university from31st August2000to31st August2011.Methods:Retrospective evaluated the case of pediatric acute poisonings admitted to the Children’s Hospital of Chongqing Medical University. Cases were divided into5groups by ages, or divided into2groups based on different origins (urban or suburban), different causes and routes of poisonings in different groups were calculated. The clinical manifestations, treatments and prognosis in acute intoxication were also studied.Result:Pediatric acute poisoning mainly happened in1-4years old children (50.02%), there was no statistical difference between genders. The common causes of poisonings were pharmacological poisoning (26.07%), food poisoning (19.50%), animal bites and stings (16.92%) and pesticide poisoning (14.73%). In the resent five years, Pharmacological poisoning rose to be the top reason of poisonings, and was mainly composed by children≤3years old (P<0.001),and urban children were more than children from suburban(P<0.001). Neurological and psychiatric drugs were the most common (32.06%) in drug poisoning. Rural children with animal bites and stings, pesticide poisonings and rodenticide poisonings were more than the urban children (P<0.001, P<0.001, P<0.05). The main poisoning causes in6-12years old group and>12years old group children were food poisoning (29.20%) and pesticide poisoning (27.27%) respectively. Accidental poison was the main route of acute poisoning in children(53.44%). The mean age was11.93±1.59years old in the intentional poisoning children, which mostly from countryside (62.5%).The main manifestations of acute poisoning included gastrointestinal symptoms (42.89%), nervous system symptoms (31.74%), respiratory symptoms (11.14%) and renal dysfunction (4.47%) in a few cases. After treatments,443cases (40.08%) were effective,519(51.64%) cases improved,29(2.89%) cases not improved, and14cases (1.39%) death.Conclusion:Pharmacological poisonings were the major cause. The causes and the routes of poisonings differed by ages and origins. Intentional poisoning in teenage should be noticed by society. The storage and management of drugs and the safety education of acute poisoning should be further emphasized which is the key point on prevention. Part II Effect of blood purification and prognosis factors analysis on serious bee stings in childrenObjective:To investigate blood purification treatment and the prognosis factors in children’s serious bee sting cases, in order to guide clinical treatment.Methods:Compared and analysed the different clinical manifestations, prognosis status and the effect of different blood purification treatments between the children with different bee sting numbers.Results:In the30cases of serious bee stings, the clinical manifestations were more severe in the patients with>10stings, who were easily suffered from multiple organs dysfunction, and had worse prognosis (P<0.05). Hemodialysis or hemoperfusion could improve the outcomes in different levels (P<0.001).Conclusions:The degree of manifestations in children is relative to the number of bee stings. Serious bee stings can involve kidney, myocardium and liver. It’s worse of the patients with>10stings in the clinical manifestations and prognosis. Blood purification is a good therapy, Early hemodialysis joint with hemoperfusion can improve the prognosis distinctly.