目的 分析儿童误服中毒的相关影响因素及临床特点,为有效防范儿童误服中毒提供科学依据。方法 对2011年11月-2016年11月武汉市儿童医院重症医学科收治的353例误服中毒住院儿童资料进行临床回顾性分析。结果 儿童误服高发年龄在1~4岁之间(275例,占77.9%),年龄中位数2.4岁,男女比1.5∶1,农村高于城镇,不同性别及不同区域在起病年龄上差异无统计学意义;误服药物均以内服药为主(157例),城镇误服内服药构成比高于农村(χ² =8.51,P<0.05),而农村在误服农药构成比显著高于城镇(χ² =18.8,P<0.05),内服药中,农村误服神经精神科用药显著高于城镇(χ² =8.43,P<0.05),而城镇误服降压药显著高于农村(χ² =4.3,P<0.05)。80.7%的家庭祖辈参与了儿童的监护,农村祖辈参与儿童监护及抚养构成比更高。结论 儿童误服中毒在不同年龄发病率明显不同,应根据不同年龄生理及心理特点进行防范误服的发生;农村留守儿童及祖辈监护可能为儿童误服的高危因素;有精神病患者、需长期口服药的慢性病以及智障儿童家庭等特殊家庭需更加重视对药物的监管。

Objective To study risk factors and clinical features associated with children accidental poisoning,in order to provide scientific evidence of further prevention. Method Totally 353 cases admitted as accidental poisoning were studied retrospectively from November 2011 to November 2016. Results Drug misusage mainly occurred in 1 to 4-year-old children (275,77.9%),the medium age was 2.4 years old,and male to female ratio was 1.5∶1,with higher proportion in rural than in urban areas.There was no statistical significant difference in the onset age in different groups by gender and area.Most accidental poisoning were oral drugs (157)with a significant higher rate than in urban area(χ²=8.51,P＜0.05).The percentages of misusage of pesticide and psychoneural drugs intoxication in rural area were significantly higher than those in urban area(χ²=18.8,8.43,both P＜0.05).However,misusage of antihypertensive drugs was more prevalent in urban than in rural area(χ²=4.3,P＜0.05).In 80.7% family of the cases,grandparents involved in caring children and the rural grandparents involved more frequently. Conclusions There is an obvious difference on children drug misusage morbidity in different age groups.Drug misusage should be prevented according to children's physiological and psychological features at different age stages.Children left-behind and cared by grandparents' in urban area may be the high risk factors.And more attention should be paid to the drug supervision especially in the families with psychiatric patients and chronic disease patients.