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目的查明一起群体性食物中毒事件的病因,避免类似事件再次发生。方法通过查阅就诊记录及面对面调查开展病例搜索,并对所有病例的基本资料、发病时间、主要临床表现、临床检测结果以及发病前饮食和饮水情况进行问卷调查,采用回顾性队列研究方法分析致病危险因素。结果该食物中毒事件共累及病例15例,均为Y市某景区道路施工队员工,罹患率为83.33%(15/18)。发病时间曲线呈单峰分布,以午餐时间作为暴露点,推算发病的最短潜伏期为0.5 h,最长潜伏期2.5 h,中位数为2 h。临床以呕吐、恶心、头晕、嗜睡、站立困难、幻觉、昏迷及瞳孔缩小等神经毒和胃肠毒共存表现为主。回顾性调查显示7月25日午餐食用蘑菇炒肉的罹患率为100.00%(15/15),未食用蘑菇炒肉的罹患率为0.00%(0/3),两组人群罹患率差异有统计学意义(P=0.00);剂量反应关系研究显示食用蘑菇炒肉越多,出现昏迷比例越高(P=0.04)。剩余野生蘑菇经形态学鉴定为残托斑鹅膏。结论该事件为一起误食残托斑鹅膏引起的食物中毒事件。
Objective To identify the etiology of a group of food poisoning incidents to avoid the recurrence of similar incidents. Methods The cases were searched by visiting records of visits and face-to-face surveys. The basic information of all cases, the onset time, major clinical manifestations, clinical test results and pre-morbid diet and drinking water were investigated by retrospective cohort study Risk factors. Results A total of 15 cases of food poisoning cases were involved, all of them were road construction workers in a scenic spot in Y City. The attack rate was 83.33% (15/18). The onset time curve showed a unimodal distribution. Lunch time was used as the exposure point. The shortest incubation period was 0.5 h and the longest incubation period was 2.5 h with a median of 2 h. Clinical vomiting, nausea, dizziness, drowsiness, standing difficulties, hallucinations, coma and miosis and other neurotoxic and gastrointestinal toxic coexist performance-based. Retrospective survey showed that the attack rate of lunch fried mushrooms on lunch on July 25 was 100.00% (15/15), the incidence of unwashed mushroom fried meat was 0.00% (0/3), there was statistical difference between the two groups The significance of learning (P = 0.00); dose-response relationship study showed that the more mushroom meat, the higher the proportion of coma (P = 0.04). The remaining wild mushrooms were morphologically identified as residual pityo ointment. Conclusion The incident was a food poisoning incident caused by the eating of Panga ointment.