ﺑﺮرﺳﯽ اﭘﯿﺪﻣﯿﻮﻟﻮژﯾﮏ ﻣﻮارد ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﮔﯿﺎﻫﺎن و ﻗﺎرچﻫﺎ در ﺑﯿﻤﺎران ﺑﺴﺘﺮي ﺑﯿﻤﺎرﺳﺘﺎن ﻟﻘﻤﺎن ﺣﮑﯿﻢ ﺗﻬﺮان ﻃﯽ ﺳﺎلﻫﺎي 92 – 1386

Epidemiological Survey of Poisoning by Plants and Mushrooms in Loghman–e- Hakim Hospital of Tehran, Iran, 2007 – 2013

ﻣﻘﺪﻣﻪ: از آﻧﺠﺎﮐﻪ در ﺟﻮاﻣﻊ اﻣﺮوزي ﻧﻪ ﺗﻨﻬﺎ ﻧﻘﺶ ﺗﻐﺬﯾﻪاي ﮔﯿﺎﻫﺎن و ﻗﺎرچﻫﺎ ﺑﺴﯿﺎر ﭘﺮرﻧﮓ و اﺳﺎﺳﯽ اﺳﺖ ﺑﻠﮑﻪ ﭘﺎﯾﻪ اﺻﻠﯽ ﺑﺴﯿﺎري از داروﻫﺎ ﻧﯿﺰ ﮔﯿﺎﻫﺎن و ﻓﺮآوردهﻫﺎي ﮔﯿﺎﻫﯽ اﺳﺖ، ﻟﺬا ﯾﮑﯽ از ﻣﺸﮑﻼت ﺳﻢﺷﻨﺎﺳﺎن ﺑﺎﻟﯿﻨﯽ ﻣﻮارد ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ اﯾﻦ ﻓﺮاوردهﻫﺎ ﻣﯽﺑﺎﺷﺪ. ﻫﺪف: ﻫﺪف از اﻧﺠﺎم اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﻣﯿﺰان ﺷﯿﻮع، ﻋﻼﺋﻢ، ﻋﻮارض، درﻣﺎنﻫﺎي ﻣﺆﺛﺮ، ﻧﻮع ﻣﺎده ﻣﺼﺮف ﺷﺪه، ﻋﻠﺖ ﻣﺼﺮف، ﻣﺤﻞ ﺗﻬﯿﻪ، ﭘﺮاﮐﻨﺶ ﺟﻨﺴﯿﺘﯽ و ﺳﻨﯽ ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﮔﯿﺎﻫﺎن و ﻗﺎرچﻫﺎ در ﺑﯿﻤﺎران ﺑﺴﺘﺮي ﺑﯿﻤﺎرﺳﺘﺎن ﻟﻘﻤﺎن ﺣﮑﯿﻢ ﺗﻬﺮان ﻣﯽﺑﺎﺷﺪ. روش ﺑﺮرﺳﯽ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﺻﻮرت ﮔﺬﺷﺘﻪﻧﮕﺮ ﺑﺎ ﺗﺪوﯾﻦ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺑﻪ ﺑﺮرﺳﯽ ﺑﯿﻤﺎران ﺑﺴﺘﺮي از آﻏﺎز ﺳﺎل 1386 ﺗﺎ ﭘﺎﯾﺎن 1392 ﭘﺮداﺧﺘﻪ اﺳﺖ. ﻧﺘﺎﯾﺞ: از 103 ﻣﻮرد ﺑﺮرﺳﯽ ﺷﺪه ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﮔﯿﺎﻫﺎن و ﻗﺎرچﻫﺎ، 64/1 درﺻﺪ ﻣﺮد و 35/9 درﺻﺪ زن ﺑﻮدهاﻧﺪ. ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ ﺑﯿﻤﺎران 21/19 ± 30/51 ﺳﺎل ﺑﻪ دﺳﺖ آﻣﺪ. ﺷﺎﯾﻊﺗﺮﯾﻦ ﻣﺎدهي ﻣﺼﺮف ﺷﺪه داﺗﻮره )34 درﺻﺪ( ﺑﻮده اﺳﺖ. از ﺳﻮي دﯾﮕﺮ ﻗﺎرچﻫﺎ در 5/8 درﺻﺪ ﻣﻮارد ﻣﺴﻤﻮﻣﯿﺖ دﯾﺪه ﺷﺪﻧﺪ. ﺑﯿﺸﺘﺮﯾﻦ ﻣﺤﻞ ﺗﻬﯿﻪ ﮔﯿﺎﻫﺎن و ﻗﺎرچﻫﺎ از ﻋﻄﺎريﻫﺎ ﮔﺰارش ﺷﺪ )27/18 درﺻﺪ(. ﻋﻠﺖ ﻣﺼﺮف در درﺟﻪ اول ﺗﺼﺎدﻓﯽ و در درﺟﻪ دوم اﯾﺠﺎد ﺳﺮﺧﻮﺷﯽ ﺑﻮده اﺳﺖ. ﭼﻬﺎر ﺑﯿﻤﺎر در ﺑﺨﺶ ﻣﺮاﻗﺒﺖﻫﺎي وﯾﮋه ﺑﺴﺘﺮي ﺷﺪﻧﺪ و ﺳﻪ ﺑﯿﻤﺎر ﻧﯿﺰ ﻧﯿﺎز ﺑﻪ اﻧﺘﻮﺑﺎﺳﯿﻮن داﺷﺘﻨﺪ. ﻣﯿﺎﻧﮕﯿﻦ ﻣﺪت زﻣﺎن ﺑﺴﺘﺮي ﺑﯿﻤﺎران 1/28 ± 1/64 روز ﺑﻪ دﺳﺖ آﻣﺪ.90 درﺻﺪ درﻣﺎنﻫﺎي اﻧﺠﺎم ﺷﺪه، ﺣﻤﺎﯾﺘﯽ ﺑﻮدﻧﺪ و 75/7 درﺻﺪ از ﺑﯿﻤﺎران ﺑﺪون ﻫﯿﭻﮔﻮﻧﻪ ﻋﺎرﺿﻪ ﺑﺎﻟﯿﻨﯽ ﺑﻬﺒﻮد ﭘﯿﺪا ﻧﻤﻮدﻧﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﮔﯿﺎﻫﺎن و ﻗﺎرچﻫﺎ از ﻋﻠﻞ ﺷﺎﯾﻊ ﻣﺴﻤﻮﻣﯿﺖ و ﻋﻤﺪﺗﺎً اﺗﻔﺎﻗﯽ ﻣﯽﺑﺎﺷﻨﺪ. در ﮐﻮدﮐﺎن ﺑﺎ اﻟﮕﻮي ﻣﺼﺮف اﺗﻔﺎﻗﯽ و ﺟﻮاﻧﺎن ﺑﺎ اﻟﮕﻮي ﺳﺮﺧﻮﺷﯽ ﺑﯿﺸﺘﺮ دﯾﺪه ﻣﯽﺷﻮد و ﻋﻤﺪﺗﺎً ﺑﺎ درﻣﺎنﻫﺎي ﺣﻤﺎﯾﺘﯽ و ﻋﻼﻣﺘﯽ ﺑﻬﺒﻮد ﭘﯿﺪا ﮐﺮده اﻧﺪ

Background: Because in todaychr('39')s societies, not only the nutritional role of plants and fungi is very high, but also the main basis of many drugs are plants and plant products, therefore one of the problems of clinical toxicologists is the toxicity of these products. Objective: This study aimed to define the prevalence, symptoms, complications, effective treatments, type of substance use, the cause of intake, location, gender distribution and age of poisoning with herbs and mushrooms in hospitalized patients of Loghman Hakim Hospital in Tehran. Methods: This is a retrospective study with questionnaire formulation. Patients reviewed from the beginning of 2007 to the end of 2013. Results: of 103 cases of poisoning with plants and mushrooms 64.1% were male, and 35.9% were female. The mean age of patients was 21.59 ± 30.51 years. The most commonly used substance is Datura (34%). On the other hand, sole mushroom ingestion was found in 5.8% of cases. The most significant source of plants and mushrooms was reported from herbal-shops (27.18%). The reason behind intake was either random or euphoria. Four patients were admitted to the intensive care unit, and three patients needed intubation. The mean hospital stay was 1.64 ± 1.28 days. Ninety percent of the treatments were supportive, and 75.7% of the patients recovered without any clinical complications. Conclusion: Poisoning with toxic plants and mushrooms is one of the frequent causes of intoxication that is often accidental. In children poisoning is inadvertent, but youth are more likely wanted to have euphoria. Treatment strategies are supportive and symptomatic.