杨奔　胡利华　邢梅　王晓玲

中图分类号 R95 文献标志码 A 文章编号 1001-0408（2018）01-0135-03

DOI 10.6039/j.issn.1001-0408.2018.01.33

摘 要 目的：减少儿童误服药物，提高儿童用药安全性。方法：统计首都医科大学附属北京儿童医院2014-2016年医院信息系统中登记的儿童误服药物例数、中毒例数、年龄分布及误服药物种类等，分析数据特点并提出相应的防范策略。结果与结论：3年内共发生儿童误服药物644例，约占儿童中毒总数（2 100例）的30%；高发年龄段集中分布在1～4岁；误服最多的药物种类是抗高血压药、解热镇痛药、镇静催眠和抗癫痫药；排前3名的药物分别为氯硝西泮（29例）、布洛芬（28例）、对乙酰氨基酚及其复方（12例）。误服原因主要与儿童好动、好奇、爱模仿等行为特点以及药物储放可及性高等有关；误服药物多为家中老年人的常用药及儿童常用解热镇痛药。建议通过减少药物在家中储放时的儿童可及性、设计儿童难以自行打开的药品包装、提高看护人用药依从性等措施，从家庭看护人、政府、医疗机构等各方面有效防范儿童误服药物的发生。

关键词 儿童；误服药物；可及性；行为特点；防范策略

ABSTRACT OBJECTIVE： To reduce childrens mistaking medicine and improve the safety of drug use in children. METHODS： Case number of childrens mistaking medicine， the number of poisoning， age distribution and types of mistaken medicine in hospital information system of Beijing Childrens Hospital of Capital Medical University during 2014-2016 were counted to analyze data characteristics and put forward relevant preventive strategies. RESULTS & CONCLUSIONS： In 3 years， there were 644 cases of childrens mistaking medicine， accounting for 30% of total number of children poisoning （2 100 cases）. A high-risk group concentrated in the 1-4 years old children. The types of mistaking medicine were mostly antihypertensive drugs， antipyretic and analgesic drugs， sedative drugs and antiepileptic drugs. Top 3 medicines were clonazepam （29 cases）， ibuprofen （28 cases）， acetaminophen and its compound （12 cases）. The main causes of mistaking medicine are mainly associated with hyperactivity， curiosity， imitation and other behavioral characteristics， high availability of drug storage， etc. Types of mistaken medicine are commonly used drugs for the elderly in the family and antipyretic analgesics commonly used in children. It is suggested to prevent the occurrence of childrens mistaking medicine from aspects of child nursing person， government and medical institutions by reducing the children accessibility of drugs stored at home， designing drug package difficult to open for children， improving medication compliance of child nursing person， etc.

KEYWORDS Children； Misusage medicine； Accessibility； Behavior characteristics； Preventive strategy

據世界卫生组织报道，近90%对儿童造成的伤害为非故意性或“事故性”事件。每年约有83万名儿童死于此类伤害，每天近2 300名。其中，道路交通碰撞、溺水、烧烫伤、跌落和中毒是儿童死于伤害的主要原因[1]。全球儿童安全组织发布的《2015儿童用药安全报告》[2]显示，药物中毒是儿童中毒的首要原因，平均每3名就诊的中毒儿童中，就有2名是药物中毒；儿童自己误服药物是儿童药物中毒的首要原因。……