某地区儿童误食有害物的临床原因分析及文献复习
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摘要
目的了解分析本地区患儿误食有害物原因,为儿童误食有害物防控提供询证依据。方法回顾性分析因误食有害物就诊的58例儿童的临床资料,对儿童误食原因等信息进行归纳分析,并采用多因素Logistic回归分析误食有害物儿童的独立危险因素。结果 58例儿童误食的有害物中,纽扣电池(36.2%)、硬币(24.1%)和玩具部件(17.2%)占前3位,家长首饰(13.8%)及其他有毒物(8.6%)分列其后。58例误食有害物儿童年龄1～7岁,平均年龄(2.8±1.5)岁;男36例,女22例,男女比为1.64∶1,男性多于女性;家长文化程度:父母双方均高中及以上17例,双方均初中及以下41例,家长文化程度偏低;单亲家庭39例,双亲家庭19例,单亲家庭占比较大;家庭环境:农村40例,城镇18例,农村:城镇为2.22∶1,农村占比大;留守35例,非留守23例,留守:非留守为1.52∶1,留守儿童占比较大。多因素Logistic回归分析显示:儿童年龄<7岁(OR=1.341, 95%CI:0.872, 9.746)、单亲家庭(OR=1.742,95%CI:1.287, 11.476)、家长文化水平偏低(OR=1.547, 95%CI:1.527, 10.647)是儿童误食有害物的独立危险因素(P<0.05)。结论留守儿童、单亲家庭儿童、家长文化水平较低儿童是导致儿童误食有害物的外在因素,加强对幼儿的看护教育,能够有效降低儿童误食。
Objective To understand and analyze the causes of children's accidental eating of harmful substances, and to provide evidence for the prevention and control of children's accidental eating harmful substances. Methods A retrospective analysis was made on the clinical data of 58 children treated for accidental eating harmful substances. The information about the causes of accidental eating harmful substances was summarized and analyzed. Multivariate logistic regression was used to analyze the independent risk factors of children's accidental eating of harmful substances. Results Among 58 cases of accidental harmful substances eaten by children, button batteries(36.2%), coins(24.1%) and toy parts(17.2%) accounted for the top 3, followed by parent jewellery(13.8%) and other toxicants(8.6%). 58 children with accidental eating harmful substances aged 1 to 7 years, with average of(2.8±1.5)years. There were 36 males and 22 females, with a male-to-female ratio of 1.64∶1 and more males than females. Parents' educational level: 17 parents were both high school and above, 41 parents were both junior high school and below, parents' educational level was low; 39 single-parent families, 19 double-parent families, single-parent families account for a larger proportion; family environment: 40 cases in rural areas, 18 cases in urban areas, rural areas:urban areas as 2.22∶1, rural areas account for a large proportion; 35 cases of left-behind, 23 cases of non-left-behind, left-behind children account for 1.52∶1, leftbehind children account for a relatively large proportion. Multivariate Logistic regression analysis showed that children' s age < 7 years old(OR = 1.341, 95% CI: 0.872, 9.746), single parent family(OR = 1.742, 95%CI: 1.287, 11.476), parents' low educational level(OR = 1.547, 95% CI: 1.527, 10.647) were independent risk factors for children's accidental eating harmful substances(P<0.05). Conclusion The low level of education of left-behind children, single-parent families and parents is an external factor that causes of children's accidental eating harmful substances. Strengthening the nursing education for young children can effectively reduce children's accidental eating.
Objective To understand and analyze the causes of children's accidental eating of harmful substances, and to provide evidence for the prevention and control of children's accidental eating harmful substances. Methods A retrospective analysis was made on the clinical data of 58 children treated for accidental eating harmful substances. The information about the causes of accidental eating harmful substances was summarized and analyzed. Multivariate logistic regression was used to analyze the independent risk factors of children's accidental eating of harmful substances. Results Among 58 cases of accidental harmful substances eaten by children, button batteries(36.2%), coins(24.1%) and toy parts(17.2%) accounted for the top 3, followed by parent jewellery(13.8%) and other toxicants(8.6%). 58 children with accidental eating harmful substances aged 1 to 7 years, with average of(2.8±1.5)years. There were 36 males and 22 females, with a male-to-female ratio of 1.64∶1 and more males than females. Parents' educational level: 17 parents were both high school and above, 41 parents were both junior high school and below, parents' educational level was low; 39 single-parent families, 19 double-parent families, single-parent families account for a larger proportion; family environment: 40 cases in rural areas, 18 cases in urban areas, rural areas:urban areas as 2.22∶1, rural areas account for a large proportion; 35 cases of left-behind, 23 cases of non-left-behind, left-behind children account for 1.52∶1, leftbehind children account for a relatively large proportion. Multivariate Logistic regression analysis showed that children' s age < 7 years old(OR = 1.341, 95% CI: 0.872, 9.746), single parent family(OR = 1.742, 95%CI: 1.287, 11.476), parents' low educational level(OR = 1.547, 95% CI: 1.527, 10.647) were independent risk factors for children's accidental eating harmful substances(P<0.05). Conclusion The low level of education of left-behind children, single-parent families and parents is an external factor that causes of children's accidental eating harmful substances. Strengthening the nursing education for young children can effectively reduce children's accidental eating.
引文
[1]中华医学会消化内镜学分会.中国上消化道异物内镜处理专家共识意见(2015年,上海).中华消化内镜杂志,2016(1):19-28.
[2]孙俊,徐伟珏,吕志,等.胃肠道多枚磁性异物3例报道及文献复习.中华实用儿科临床杂志,2016,31(17):1339-1342.
[3]王立,谢鹏,贺小武,等.3例误食异物致消化道穿孔诊治失误分析.实用临床医学,2017,18(6):46-47.
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[6]周良,侯广军,耿宪杰,等.小儿误食枣核致消化道穿孔8例临床分析.临床小儿外科杂志,2017,16(3):301-304.
[7]刘杨桦,冯泽荣,黄红艺,等.腹腔镜下小儿肠道内异物取出术7例分析.临床小儿外科杂志,2014,13(3):221-222.
[8]朱颖,董扬,徐达良,等.100例儿童急性中毒临床特点及血液灌流治疗效果分析.安徽医学,2018,39(5):580-581.
[9]周静,袁媛,郎楠,等.中国大陆地区蘑菇中毒事件及危害分析.中华急诊医学杂志,2016,25(6):724-726.
[10]周敏,徐雷鸣,瞿春莹,等.内镜下上消化道异物取出术应用分析.国际消化病杂志,2017,37(2):120-124.
[11]王可为,吴欢欢,仇君,等.2011-2015年长沙市某医院儿童呼吸道异物城乡分布特征.使用预防医学,2018,25(3):325-327.
[12]诸建明,林杰,黄婷,等.小儿误食异物致消化道穿孔24例救治分析.中华急诊医学杂志,2014,23(4):454-455.
[13]刘圣娣,乔莉,蒋雷,等.大型综合性教学医院抢救室479例急性中毒的流行病学分析.临床急诊杂志,2017(4):248-252.
[14]林红,许宝珠,林大东,等.儿童意外损伤的危险因素分析.东南国防医药,2013,15(4):409-410.
[2]孙俊,徐伟珏,吕志,等.胃肠道多枚磁性异物3例报道及文献复习.中华实用儿科临床杂志,2016,31(17):1339-1342.
[3]王立,谢鹏,贺小武,等.3例误食异物致消化道穿孔诊治失误分析.实用临床医学,2017,18(6):46-47.
[4]朱真闯,闰学强,杨俊,等.小儿误食异物致消化道穿孔12例诊治分析.北京大学学报(医学版),2017,(5):924-926.
[5]朱莉,刘文莉,靳蓉,等.儿童上消化道异物的内镜处理.实用儿科临床杂志,2010,25(13):1031-1032.
[6]周良,侯广军,耿宪杰,等.小儿误食枣核致消化道穿孔8例临床分析.临床小儿外科杂志,2017,16(3):301-304.
[7]刘杨桦,冯泽荣,黄红艺,等.腹腔镜下小儿肠道内异物取出术7例分析.临床小儿外科杂志,2014,13(3):221-222.
[8]朱颖,董扬,徐达良,等.100例儿童急性中毒临床特点及血液灌流治疗效果分析.安徽医学,2018,39(5):580-581.
[9]周静,袁媛,郎楠,等.中国大陆地区蘑菇中毒事件及危害分析.中华急诊医学杂志,2016,25(6):724-726.
[10]周敏,徐雷鸣,瞿春莹,等.内镜下上消化道异物取出术应用分析.国际消化病杂志,2017,37(2):120-124.
[11]王可为,吴欢欢,仇君,等.2011-2015年长沙市某医院儿童呼吸道异物城乡分布特征.使用预防医学,2018,25(3):325-327.
[12]诸建明,林杰,黄婷,等.小儿误食异物致消化道穿孔24例救治分析.中华急诊医学杂志,2014,23(4):454-455.
[13]刘圣娣,乔莉,蒋雷,等.大型综合性教学医院抢救室479例急性中毒的流行病学分析.临床急诊杂志,2017(4):248-252.
[14]林红,许宝珠,林大东,等.儿童意外损伤的危险因素分析.东南国防医药,2013,15(4):409-410.