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目的探讨我国医疗机构救治急性甲醇中毒能力的现状。方法采用文献计量学法,在“中国知网”和“万方医学网”上,以“急性”、“中毒”和“甲醇”为主题词检索2000年1月1日至2013年6月30日在国内公开杂志上发表的急性甲醇中毒文献。自行设计调查表,收集省级中毒救治基地和省、市级非中毒救治基地医疗机构(简称“非中毒救治机构”)关于急性甲醇中毒的救治情况,评估其救治能力和资源配置情况。结果收集到国内公开杂志上发表的急性甲醇中毒患者592例,其中7例职业性中毒患者,585例生活性中毒患者。592例急性甲醇中毒患者中,有190例患者进行了血清甲醇检测,全部患者均未进行血清甲酸检测;19例患者行动脉血气分析。回收省级中毒救治基地有效问卷16份,非中毒救治机构有效问卷14份。调查结果显示,分别有31.25%和12.50%的省级中毒救治基地能够分别开展血清甲醇、甲酸检测,14家非中毒救治机构均不具备开展血清甲醇、甲酸检测能力;31.25%的省级中毒救治基地和7.14%非中毒救治机构具备开展血清乙醇检测的能力;87.50%的省级中毒救治基地和85.71%的非中毒救治机构具备开展动脉血气分析能力。结论血清甲醇检测可作为病因学依据,医疗机构应开展血清甲酸检测。需要进一步规范急性甲醇中毒代谢性酸中毒的治疗,普及动脉血气分析,更多地采用血液透析技术清除毒物。
Objective To explore the current situation of medical institutions in China in treating acute methanol poisoning. Methods The bibliometrics method was used to search 2000 with the keywords of “acute”, “poisoning” and “methanol” on “China Knitting Net” and “Wanfang Medical Network” January 1 to June 30, 2013 published in the domestic public journal acute methanol poisoning literature. A questionnaire shall be designed by itself to collect information on the treatment of acute methanol poisoning and the treatment and resource allocation of provincial poisoning treatment bases and medical institutions of provincial and municipal non-poisonous treatment bases (referred to as “non-poison treatment centers”). Results A total of 592 acute methanol poisoning cases were reported in domestic public magazines, including 7 cases of occupational poisoning and 585 cases of life poisoning. Of the 592 acute methanol poisoning patients, 190 were tested for serum methanol and none of the patients were tested for formic acid in their blood serum; arterial blood gas analysis was performed in 19 patients. 16 valid questionnaires were collected from provincial poisoning treatment bases and 14 valid questionnaires from non-toxic treatment institutions. The survey results showed that 31.25% and 12.50% provincial poisoning treatment bases were able to carry out serum methanol and formic acid detection respectively, and none of the 14 non-toxic treatment institutions had the ability to carry out serum methanol and formic acid detection. 31.25% provincial poisoning treatment Base and 7.14% non-toxic treatment agencies have the ability to carry out serum ethanol test; 87.50% provincial poisoning treatment bases and 85.71% non-poison treatment institutions have arterial blood gas analysis capability. Conclusion Serum methanol test can be used as the etiology, medical institutions should carry out serum formic acid test. Need to further regulate the treatment of acute methanol poisoning acidosis, popularization of arterial blood gas analysis, more use of hemodialysis technology to remove the poison.