0-18 YAŞ ARASI ÇOCUKLARDA ASETAMİNOFEN ZEHİRLENMESİNİN RETROSPEKTİF OLARAK İNCELENMESİ

Yıl 2025, Cilt: 6 Sayı: 2, 73 - 78, 31.08.2025

Gülhan Ünlü , Erdal Ünlü , Halime Tozak Yıldız , Ülken Tunga Babaoğlu , Gamze Turna Saltoğlu

https://doi.org/10.52831/kjhs.1636868

Öz

Amaç: Asetaminofen, çocuklarda ateş düşürücü ve ağrı kesici olarak yaygın bir şekilde kullanılmaktadır. Asetaminofen zehirlenmesi, dünya genelinde en yaygın ilaç zehirlenmelerinden biridir. Buna rağmen, tedaviye yönelik hâlâ bir fikir birliği bulunmamaktadır. Bu çalışma, akut asetaminofen zehirlenmesi nedeniyle hastaneye yatırılan 0-18 yaş arasındaki pediyatrik hastaların klinik özelliklerini, laboratuvar bulgularını ve tedavi yaklaşımlarını değerlendirmeyi amaçlamaktadır.
Yöntem: Bu çalışmada Ocak 2016-Ocak 2021 tarihleri arasında Kırşehir Eğitim ve Araştırma Hastanesi Acil Servisine asetaminofen alımı ile başvuran ve Çocuk Sağlığı ve Hastalıkları Servisine yatırılan 0-18 yaş arası çocukların dosyaları retrospektif olarak incelendi. Hastaların demografik özellikleri, asetaminofen alım nedeni, semptomları, laboratuvar bulguları ve tedavi süreçleri değerlendirildi. Verilerin analizinde tanımlayıcı istatistikler için sayı (n), yüzde (%), median ve çeyreklikler (Q1-Q3) kullanıldı.
Bulgular: Ocak 2016-Ocak 2021 tarihleri arasında toplam 38 hasta asetaminofen zehirlenmesi ile başvurmuştur. Hastaların %36.8’i 0-5 yaş, %63.2’si 14-18 yaş grubundaydı. 5-14 yaş aralığında herhangi bir vaka tespit edilmedi. %63.2’si intihar amacıyla ilaç almış, intihar amacıyla ilaç alanların da %76’sı kadındı. Klinik semptomlar nadiren gözlenmiştir. Hastaların %73.7’sine aktif kömür, %68.2’sine mide lavajı, %23.7’sine NAC uygulanmıştır. ALT, AST ve protrombin zamanı median değerleri sırasıyla 15.24, 19.50 ve 12.60 olarak bulundu.
Sonuç: Çalışmamız, küçük çocuklarda asetaminofen zehirlenmesinin genellikle kaza sonucu, ergenlerde ise intihar amacıyla meydana geldiğini göstermektedir. Kadın hastaların intihar amaçlı ilaç alım oranı daha yüksek bulundu. Sonuçlar literatürdeki benzer çalışmalarla uyumludur. Zehirlenmeleri önlemek için ebeveyn farkındalığının artırılmasına, ilaçların güvenli saklanmasına, erişimi kısıtlayan müdahalelere, risk altındaki bireylerin belirlenmesine yönelik çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Çocuk , Asetaminofen Zehirlenmesi , Retrospektif Çalışma

RETROSPECTIVE INVESTIGATION OF ACETAMINOPHEN POISONING IN CHILDREN AGED 0-18 YEARS

Öz

Objective: Acetaminophen is widely used as an antipyretic and analgesic in children. Acetaminophen poisoning is one of the most common drug poisonings worldwide. Despite this, there is still no consensus on treatment. This study aims to evaluate the clinical characteristics, laboratory findings, and treatment approaches of pediatric patients aged 0-18 years who were hospitalized due to acute acetaminophen poisoning.
Method: In this retrospective study, medical records of children aged 0-18 years who were admitted to the Emergency Department of Kırşehir Training and Research Hospital with acetaminophen ingestion and subsequently hospitalized in the Pediatric Health and Diseases Department between January 2016 and January 2021 were reviewed. Patients' demographic characteristics, reasons for acetaminophen intake, symptoms, laboratory findings, and treatment processes were analyzed. Descriptive statistics such as number (n), percentage (%), median, and quartiles (Q1-Q3) were used for data analysis.
Results: Between January 2016 and January 2021, a total of 38 patients were admitted due to acetaminophen poisoning. Among them, 36.8% were aged 0-5 years, while 63.2% were in the 14-18 age group. There were no recorded cases in the 5-14 year age group. Clinical symptoms were rarely observed. A total of 63.2% of the cases involved suicidal ingestion, and 76% of these patients were female. Activated charcoal was administered to 73.7% of the patients, gastric lavage to 68.2%, and NAC to 23.7%. The median values for ALT, AST, and prothrombin time were 15.24, 19.50, and 12.60, respectively.
Conclusion: Our study demonstrates that acetaminophen poisoning in young children is usually accidental, whereas in adolescents, it primarily occurs with suicidal intent. The rate of drug ingestion for suicidal purposes was higher among female patients. The results are consistent with similar studies in the literature. To prevent poisoning cases, increasing parental awareness, ensuring safe medication storage, implementing restricted access interventions, and identifying at-risk individuals are necessary.

Anahtar Kelimeler

Child , Acetaminophen Poisoning , Retrospective Study

Kaynakça

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