| Background Aluminum phosphide is commonly known as "smoked wheat medicine" in northern Anhui,which is mainly used for farmers to harvest wheat in summer and place it in wheat barn to kill insects and prevent insects.Due to the low price of phosphating rate,high efficiency and lax market supervision,it is easy to obtain and widely used in rural areas in northern Anhui.The number of early aluminum phosphide poisoning is small,mainly oral suicide poisoning,and did not cause enough attention of clinicians.As the number of patients with acute aluminum phosphide poisoning gradually increased,the number of inpatients admitted to the hospital in 2016 alone rose to more than 10 times as many as five years ago,and the characteristics of related poisoning,such as the onset of the disease,the etiology and the time of the onset of the disease,all showed obvious changes,so this kind of poisoning has gradually attracted the attention of emergency doctors.This study attempts to explore the pathogenesis of acute aluminum phosphide poisoning through epidemiological research,and provide theoretical basis for the treatment of acute aluminum phosphide poisoning in Fuyang area and the formulation of relevant preventive measures,laws and regulations.Objective Explorethe the epidemiological characteristics of acute aluminum phosphide poisoning,in order to provide theoretical basis for the treatment of this kind of poisoning in Fuyang area and to formulate relevant preventive 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 data statistics were carried out on the source,age,sex,marriage,education,month and age of onset,etiology,poisoning pathway and mortality,and death-related factors of the patients,and statistical analysis was given by using SPSS16.0 software.Results The proportion of men and women included was 1.14:1,and the age ofonset was mainly in the age group 20 and below,with a total of 98 cases(62.0%).The occupation distribution was mainly student and farmer,97 cases(61.4%)and 46 cases(29.1%)respectively.The general education level of poisoning patients is not high,mainly concentrated in junior high school and below education level,a total of 151cases(95.6%).The sources of patients were mainly distributed in rural areas,with a total of 149 cases(94.3%).The number of patients showed an increasing trend year by year,reaching the highest peak in 2016,with 56 cases(35.4%)of poisoning,of which 47 cases(29.4%)were mainly inhaled poisoning,which exceeded oral poisoning patients.After 2016,the number of patients began to decrease year by year,and by 2018,the number of poisoning 12 cases in 2018.The time of onset of the patients was mainly distributed in June,July and August,with a total of 110 cases(69.5%),especially the largest number of patients in July and August,with a total of94 cases admitted(59.5%).The main cause of poisoning was accidental poisoning(104 cases),including 96 cases of inhalation poisoning and 8 cases of accidental administration.There were 98 cases(62.0%)with age <20 years of age,of which 93 were accidental poisoning,89 were absorbed through the respiratory tract(56.3%),and more than 20 years of age were oral suicide(oral/suicide:53/49).The etiology and poisoning pathways of the nine age groups from 0 to 90 years were compared respectively,with statistical significance(P <0.05).The total mortality of 158 patients with aluminium phosphide poisoning was 15.2%(24/158),72.7%(24/33)for severe poisoning,24 cases with a definite oral dose of 1 or more,and 45.8%(11/24).The fatality rate of oral poisoning was higher than that of inhalation poisoning[ 25.8%(16/62)compared to 8.3%(8/96),P <0.05 ].The fatality rate of suicide factors was higher than that of inhalation poisoning [ 29.6%(16/54)compared to7.7%(8/104),P <0.05 ].the metabolic acidosis,acute heart failure,shock,and incidence of acute respiratory failure and mods in the death group and survival group were significantly higher than those in the survival group(p <0.05).Spearman grade correlation analysis was performed on related indexes of poisoning patients,poisoning pathway(oral: rs=0.238 P=0.003),etiology(suicide: rs=0.290 P=0.000),metabolic acidosis(rs=0.737 P=0.000),acute heart failure(rs=0.689 P=0.000),shock (rs=0.754 P=0.000),and acute respiratory failure(rs=0.618 P=0.000)and MODS(rs=0.875 P=0.000)were correlated with the death of the patients(P <0.05).Conclusions Acute aluminum phosphide poisoning patients mainly from rural areas,mainly farmers and left-behind students,low level of education,mostly concentrated in junior high school and below the education level,slightly more men than women.The main causes of juvenile and children are accidental inhalation poisoning,and adult patients are mainly oral suicide poisoning.The number of patients with poisoning increased year by year,reaching its highest peak in 2016,and then began to decrease year by year.The incidence of poisoning is seasonally intensive,mainly in June,July and August,especially in July and August.The fatality rate of oral poisoning was higher than that of inhalation poisoning,and the fatality rate of suicide poisoning was higher than that of accidental factors.Factors such as cause of poisoning(suicide),route of poisoning(oral),metabolic acidosis,acute heart failure,shock,and acute respiratory failure and mods are closely related to mortality.It is helpful to reduce the incidence and mortality of acute aluminum phosphide poisoning by doing a good job in popularization of science and cultural propaganda,prevention and control and market supervision,especially for children and adolescents left behind. |
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