Öz
Çocukluk
çağı zehirlenmeleri acil servise başvuruların önemli nedenleri arasındadır. Bu
çalışmada hastalarımızda görülen çocukluk çağı zehirlenmelerinin epidemiyolojik
ve klinik özelliklerinin retrospektif olarak belirlenmesi amaçlandı. Bu
çalışmada 01.01.2011 ile 14.06.2015 tarihleri arasında hastanemiz çocuk acil
servisine zehirlenme nedeniyle getirilen 1168 olgu değerlendirildi. Zehirlenmelerin
yaş gruplarına göre dağılımına bakıldığında en sık 13 ay-48 ay grubunda (%44.18) olduğu görüldü. Zehirlenme etkenlerine bakıldığı zaman en
sık nedenin 545 vaka ile ilaçlar nedenli olduğu görüldü(%47.9). İkinci
sırada 283 vaka sayısı (%24.9) ile
karbonmonoksit zehirlenmeleriyer almaktaydı. Zehirlenmeye neden olan ilaç etkenleri
arasında ilk sırada 127 vaka (%21,67)
ile analjezik/antipiretik ve kas gevşeticiler;
%20,3 ‘lük oran ile çoklu ilaç alımları ikinci sırada; duygu durum
düzenleyiciler de üçüncü sırada yer
almakta idi. Duygu durum düzenleyiciler arasında en çok Trisiklik
antidepresanlar ile olan zehirlenme
etkenlerine rastladık. Zehirlenme etkeni
olan maddelerin alınış yollarına bakıldığında; 792’sinde sindirim yoluyla
(%67,8), 301’inde solunum yoluyla (%25,7) alındığı bulundu. Çalışmamızda
zehirlenme etkenleri olarak ilaçlar birinci sırada yer almakta idi. Daha önce
ki Türkiye çalışmalarından farklı olarak; Opioid analjezikler ve anti
neoplastik ajanlar ile zehirlenmelere de rastlanıldı. Çocukluk çağı
zehirlenmeleri genelde sekelsiz atlatılsa bile hala acil servis başvurularında
önemli bir yer tutmaktadır.
Anahtar Kelimeler
Kaynakça
- Uziel Y, Adler A, Aharonowitz G, Franco S, Fainmesser P, Wolach B.” Un Intentional Childhood Poisoning in the Sharon Area in Israel.” Pediatric Emergency Care 2005;21(4):248-2512. Kavalcı C, Demir A, Arslan ED, Yilmaz F, Durdu T, Yel C, Gülsüm et all.”Adult Poisoning Cases in Ankara: Capital City of Turkey” International Journal of Clinical Medicine 2012;3-7A,Article ID:26339 DOI:10.4236/ijcm.2012.37A129 3. J. Kristinsson, R. Palsson, G. A. Gudjonsdottır, M. Blondal, S. Gudmundsson and C. P. Snook, “Acute Poisonings in Iceland: A Prospective Nationwide Study,” Clinical Toxicology, Vol. 46, No. 2, 2008, pp. 126-132. doi:10.1080/155636507014382684. Uludağ Ö, Tutak A, Doğukan M, Kaya R, Tutak AŞ, Çelik M “Characteristics of poisoningcases in Adiyaman City” Dicle Medical Journal 2015;42(3)284-2885. Akbay-Öntürk Y, Uçar B.”Retrospective Analysis of Childhood Poisoning at Eskişehir Region “ Journal of Child Health Disease 2003; 46:103-13. ISSN: 0010 - 01616. Kırel B, Unluoglu I, Dogruel N, Koçak K, “Retrospective Analysis of Childhood Poisoning at Eskişehir Region” Turkiye Klinikleri J Med Sci 2000;9:158-163. ISSN: 1300-0292 7. Şahin S, Carman KB, Dinleyici EC, “AcutePoisoning in children; Data of a Pediatric Emergency Unit”, Iran J Ped. Dec 2011;21(4);479-484.8. Mintegi S, Fernandez A, Alustiza J, Canduela V, Mongil I, Caubet I et all .” Emergency Visits for Childhood Poisoning: A 2 Year Prospective Multicenter Survey in Spain.” Pediatric Emergency Care 2006;22(5):334-8.9. Burillo- Putze G, Munne P, Duenas A, et al. “National Multicentre Study of Accute İntoxication İn Emergency Departments of Spain.” European Journal of Emergency Medicine 2003;10(2):101-4. 10. Dereci S, Koca T, Gençer A, Serdaroğlu F, Akçam M. “ Evaluation of Childhood Poisoning in Isparta Region “Dicle Medical Journal / 2015; 42 (3): 319-325doi: 10.5798/diclemedj.0921.2015.03.058211. Kelebek F , Satar S , Kozacı N , Açıkalın A , Gülen M , Acehan S “Emergency Medicine Admissions of Pediatric Intoxicated Cases” The Journal of Academic Emergency Medicine “2014; 13: 67-7012. Eldridge DL, Eyk JV, Kornegay C. “Pediatric Toxicology” Emergency Medicine Clin North Am 2007;15:283-30813. Demirgan EB, Erol M, Demirgan S, Yiğit Ö, Türkay M. Retrospective Evaluation of Drug Poisoning Cases Referring to Pediatric Emergency Policlinic”, The Medical Journal of Okmeydanı Training and Resarch Hospital 30(3):128-134, 2014 doi:10.5222/otd.2014.12814. Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss.”1999 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.” Am. J. Emerg. Med. 2000;18(5):517–574.15. Özdemir R, Bayrakci B, O Tekşam, Yalçın B, Kale G ” Thirty-threeyear experience on childhood poisoning. “The Turkish Journal of Pediatrics, 2012;54:251-259.16. Yakar B “The Familial Factors and Demographic Characteristics of Children with Drug Poisoning” Anatolian Journal of Clinical Investigations 2015;9(4):189-19317. Kandolot M, Akyıldız B, Görözen F, Kutoğlu S, Patıroğlu S. “Evaluation of the poisoning cases who applied to the Pediatrics Emergency Unit” Journal of Child Health Disease,2009;52:68-74 ISSN: 0010 – 016118. Keskinbora K, Aydınlı I, “An atypical opioid analgesic: Tramadol”, The Journal of The Turkish Society of Algology 2006;18(1):5-1919. Rosenbaum TG, Kou M.” Are one or two dangerous? Tricyclic antidepressant exposure in toddlers.” The Journal of Emergency Medicine, 2005;28(2):169–17420. Yoldaş T, Güler SK, Güneş N, Çokal BG,Yurtdaş M” A Case Report of Mortal Intoxication of Amitriptyline” Ankara Medical Journal, 2014, 14(Addition- 1): 12 – 1421. Kant S ,Liebelt E,” Recognizing Serotonin Toxicity in The Pediatric Emergency Department. “Pediatric Emergancy Care, 2012;28(8):817-21; quiz 822-4. doi: 10.1097/PEC.0b013e31826289d922. Erkekoğlu P, Giray B, Şahin G. “Toxicological evaluation of tricyclic antidepressant use in risky groups” Acta Medica (Hacettepe Medical Journal) 2008; 39:22-30. eISSN:2147-9488.23. Ayaz T, Bilir Ö, Ersunan G, Şahin OZ, Yavaşi Ö, Rakıc H. ” Evaluation of Drug Intoxications Due To Suicides” Konuralp Medical Journal 2015;7(1):53-56.24. Sargın AK, Oğuz EO, Can B , Saran Y “Morphological Alerations of Methotrexate in Mouse Kidney”Anadolu University Journal of Science and Technology, 2009;10(1):197-203. http://hdl.handle.net/11421/1678
Öz
Childhood
poisonings are among the major causes of the admission to emergency units. In
this study, we aimed retrospectively to determine the epidemiological and
clinical characteristics of childhood poisoning among our patients. This study
consisted of 1168 cases who admitted to pediatric emergency unit of our
institution due to poisoning between 01/01/2011 and 14/06/2015. Poisonings were
common at 13 - 48 months (44.18%). The most common poisoning agent was drugs
with 545 cases (47.9%),while the second common factor was carbon monoxide poisoning with 283 cases
(24.9%). Analgesic / antipyretic agents and muscle relaxants were common agents
that leads to drug poisonings(127cases, 21.67%); getting multi drugs(20.3%) and
mood stabilizers followed them. Among mood stabilizers, tricyclic
antidepressants were the most causes of drug poisonings. 792 cases(67.8%) exposed to poisoning agent by digestion (67.8%) and 301cases (25.7%) by inhalation. Drugs
appeared to be primer poisoning agents in our study. Unlike the previous studies in Turkey;
poisoning by opioid analgesics and anti-neoplastic agents were also found.
Although childhood poisonings are often circumvented without sequelae, they are
stil major causes of admission to emergency units.
Anahtar Kelimeler
Kaynakça
- Uziel Y, Adler A, Aharonowitz G, Franco S, Fainmesser P, Wolach B.” Un Intentional Childhood Poisoning in the Sharon Area in Israel.” Pediatric Emergency Care 2005;21(4):248-2512. Kavalcı C, Demir A, Arslan ED, Yilmaz F, Durdu T, Yel C, Gülsüm et all.”Adult Poisoning Cases in Ankara: Capital City of Turkey” International Journal of Clinical Medicine 2012;3-7A,Article ID:26339 DOI:10.4236/ijcm.2012.37A129 3. J. Kristinsson, R. Palsson, G. A. Gudjonsdottır, M. Blondal, S. Gudmundsson and C. P. Snook, “Acute Poisonings in Iceland: A Prospective Nationwide Study,” Clinical Toxicology, Vol. 46, No. 2, 2008, pp. 126-132. doi:10.1080/155636507014382684. Uludağ Ö, Tutak A, Doğukan M, Kaya R, Tutak AŞ, Çelik M “Characteristics of poisoningcases in Adiyaman City” Dicle Medical Journal 2015;42(3)284-2885. Akbay-Öntürk Y, Uçar B.”Retrospective Analysis of Childhood Poisoning at Eskişehir Region “ Journal of Child Health Disease 2003; 46:103-13. ISSN: 0010 - 01616. Kırel B, Unluoglu I, Dogruel N, Koçak K, “Retrospective Analysis of Childhood Poisoning at Eskişehir Region” Turkiye Klinikleri J Med Sci 2000;9:158-163. ISSN: 1300-0292 7. Şahin S, Carman KB, Dinleyici EC, “AcutePoisoning in children; Data of a Pediatric Emergency Unit”, Iran J Ped. Dec 2011;21(4);479-484.8. Mintegi S, Fernandez A, Alustiza J, Canduela V, Mongil I, Caubet I et all .” Emergency Visits for Childhood Poisoning: A 2 Year Prospective Multicenter Survey in Spain.” Pediatric Emergency Care 2006;22(5):334-8.9. Burillo- Putze G, Munne P, Duenas A, et al. “National Multicentre Study of Accute İntoxication İn Emergency Departments of Spain.” European Journal of Emergency Medicine 2003;10(2):101-4. 10. Dereci S, Koca T, Gençer A, Serdaroğlu F, Akçam M. “ Evaluation of Childhood Poisoning in Isparta Region “Dicle Medical Journal / 2015; 42 (3): 319-325doi: 10.5798/diclemedj.0921.2015.03.058211. Kelebek F , Satar S , Kozacı N , Açıkalın A , Gülen M , Acehan S “Emergency Medicine Admissions of Pediatric Intoxicated Cases” The Journal of Academic Emergency Medicine “2014; 13: 67-7012. Eldridge DL, Eyk JV, Kornegay C. “Pediatric Toxicology” Emergency Medicine Clin North Am 2007;15:283-30813. Demirgan EB, Erol M, Demirgan S, Yiğit Ö, Türkay M. Retrospective Evaluation of Drug Poisoning Cases Referring to Pediatric Emergency Policlinic”, The Medical Journal of Okmeydanı Training and Resarch Hospital 30(3):128-134, 2014 doi:10.5222/otd.2014.12814. Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss.”1999 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.” Am. J. Emerg. Med. 2000;18(5):517–574.15. Özdemir R, Bayrakci B, O Tekşam, Yalçın B, Kale G ” Thirty-threeyear experience on childhood poisoning. “The Turkish Journal of Pediatrics, 2012;54:251-259.16. Yakar B “The Familial Factors and Demographic Characteristics of Children with Drug Poisoning” Anatolian Journal of Clinical Investigations 2015;9(4):189-19317. Kandolot M, Akyıldız B, Görözen F, Kutoğlu S, Patıroğlu S. “Evaluation of the poisoning cases who applied to the Pediatrics Emergency Unit” Journal of Child Health Disease,2009;52:68-74 ISSN: 0010 – 016118. Keskinbora K, Aydınlı I, “An atypical opioid analgesic: Tramadol”, The Journal of The Turkish Society of Algology 2006;18(1):5-1919. Rosenbaum TG, Kou M.” Are one or two dangerous? Tricyclic antidepressant exposure in toddlers.” The Journal of Emergency Medicine, 2005;28(2):169–17420. Yoldaş T, Güler SK, Güneş N, Çokal BG,Yurtdaş M” A Case Report of Mortal Intoxication of Amitriptyline” Ankara Medical Journal, 2014, 14(Addition- 1): 12 – 1421. Kant S ,Liebelt E,” Recognizing Serotonin Toxicity in The Pediatric Emergency Department. “Pediatric Emergancy Care, 2012;28(8):817-21; quiz 822-4. doi: 10.1097/PEC.0b013e31826289d922. Erkekoğlu P, Giray B, Şahin G. “Toxicological evaluation of tricyclic antidepressant use in risky groups” Acta Medica (Hacettepe Medical Journal) 2008; 39:22-30. eISSN:2147-9488.23. Ayaz T, Bilir Ö, Ersunan G, Şahin OZ, Yavaşi Ö, Rakıc H. ” Evaluation of Drug Intoxications Due To Suicides” Konuralp Medical Journal 2015;7(1):53-56.24. Sargın AK, Oğuz EO, Can B , Saran Y “Morphological Alerations of Methotrexate in Mouse Kidney”Anadolu University Journal of Science and Technology, 2009;10(1):197-203. http://hdl.handle.net/11421/1678
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | ORİJİNAL MAKALELER / ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Nisan 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 41 Sayı: 2 |