پديد آورندگان :
ﻧﻮري، ﺳﻌﯿﺪ دانشگاه علوم پزشكي شهيد بهشتي - بيمارستان لقمان حكيم - گروه بيماريهاي مغز و اعصاب - كميته پژوهشي دانشجويان , ﺷﺮﯾﻒ، ﻣﺤﻤﺪرﺿﺎ دانشگاه علوم پزشكي كاشان - بيمارستان شهيد بهشتي - مركز تحقيقات بيماريهاي عفوني - گروه جراحي عمومي , ﻓﺮﻫﻨﮓ، ﻧﺠﻼ دانشگاه علوم پزشكي شهيد بهشتي - بيمارستان لقمان حكيم - كميته پژوهشي دانشجويان
چكيده فارسي :
زﻣﯿﻨﻪ و ﻫﺪف: ﻫﺮ ﻣﺎده ﺗﻮﮐﺴﯿﮏ ﺑﺴﺘﻪ ﺑﻪ ﺗﻐﯿﯿﺮات ﻓﯿﺰﯾﻮﻟﻮژﯾﮏ اﺗﻔﺎق اﻓﺘﺎده در ﺣﯿﻦ ﺗﻤﺎس ﺗﻈﺎﻫﺮات ﻣﻨﺤﺼﺮ ﺑﻪ ﻓﺮد ﺧﻮد را دارد. ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﺳﺮب ﻣﯽﺗﻮاﻧﺪ ﻣﻨﺠﺮ ﺑﻪ ﻋﻼﺋﻢ و ﻧﺸﺎﻧﻪﻫﺎي ﻣﺘﻌﺪدي ﺷﻮد. ﻫﺪف ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺮرﺳﯽ ﺧﺼﻮﺻﯿﺎت درد ﺷﮑﻤﯽ
ﺑﯿﻤﺎران ﻣﺴﻤﻮم ﺑﺎ ﺳﺮب ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﻟﻘﻤﺎن ﺣﮑﯿﻢ ﺗﻬﺮان در ﻃﯽ ﺳﺎل 1396-1395 ﻣﯽﺑﺎﺷﺪ.
ﻣﻮاد و روش ﻫﺎ: ﺗﻤﺎم ﺑﯿﻤﺎران دﭼﺎر ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﺳﺮب ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﺑﯿﻤﺎرﺳﺘﺎن ﻟﻘﻤﺎن ﺣﮑﯿﻢ ﺷﻬﺮ ﺗﻬﺮان از ﻓﺮوردﯾﻦ ﻣﺎه 1395 ﻟﻐﺎﯾﺖ ﺷﻬﺮﯾﻮر ﻣﺎه 1396 ﮐﻪ ﺗﺤﺖ ﻣﺸﺎوره ﺟﺮاﺣﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ، ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ و اﻃﻼﻋﺎت در ﻓﺮم ﺟﻤﻊ آوري اﻃﻼﻋﺎت ﺛﺒﺖ ﺷﺪ. ﭘﺮﺳﺸﻨﺎﻣﻪ ﺷﺎﻣﻞ اﻃﻼﻋﺎت دﻣﻮﮔﺮاﻓﯿﮏ )ﺳﻦ، ﺟﻨﺲ، ﺗﺤﺼﯿﻼت، ﺷﻐﻞ( ﺳﺎﺑﻘﻪ ﺑﯿﻤﺎري ﻗﺒﻠﯽ، ﺳﺎﺑﻘﻪ اﻋﺘﯿﺎد )ﻧﻮع ﻣﺎده ﻣﺼﺮﻓﯽ، روش ﻣﺼﺮف ﻣﺎده ﻣﺨﺪر، ﻣﺪت زﻣﺎن ﻣﺼﺮف ﻣﺎده ﻣﺨﺪر(، ﻣﻌﺎﯾﻨﻪ ﺷﮑﻢ، ﺳﻄﺢ ﺳﺮب ﺧﻮن، ﻫﻤﻮﮔﻠﻮﺑﯿﻦ و ﻧﺘﺎﯾﺞ اﻗﺪاﻣﺎت ﭘﺎراﮐﻠﯿﻨﯿﮏ )ﮔﺮاﻓﯽ ﺳﺎده ﺷﮑﻢ( ﺑﻮد. اﻃﻼﻋﺎت ﺑﺎ اﺳﺘﻔﺎده از ﻧﺮم اﻓﺰار آﻣﺎري 16 SPSS ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ و
0.05< P-value ﺑﻪ ﻋﻨﻮان ﺳﻄﺢ ﻣﻌﻨﺎداري در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ.
ﯾﺎﻓﺘﻪ ﻫﺎ: ﺗﻌـﺪاد 200 ﺑﯿﻤـﺎر ﮐﻪ ﺗﺸﺨﯿـﺺ ﻣﺴﻤـﻮﻣﯿﺖ ﺑﺎ ﺳـﺮب ﺑﺮ اﺳﺎس ﺷﺮح ﺣـﺎل و ﺳﻄﺢ ﺳﺮب ﺳـﺮﻣﯽ ﻣﺴﺠـﻞ ﺷـﺪه ﺑﻮد، ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. از اﯾﻦ ﺗﻌﺪاد 184 ﻣﻮرد ﻣﺬﮐﺮ )92%( و 16 ﻣﻮرد ﻣﺆﻧﺚ )8%( ﺑﻮدﻧﺪ. ﻣﯿﺎﻧﮕﯿﻦ ﺳﻦ ﺑﯿﻤﺎران 4/5 ± 48 اﻧﺤﺮاف ﻣﻌﯿﺎر ± ﻣﯿﺎﻧﮕﯿﻦ( ﺑﻮد. درد ﺷﮑﻤﯽ ﺑﯿﻤﺎران ﺑﯿﺸﺘﺮ در ﭘﺮي آﻣﺒﻠﯿﮑﺎل، ﻣﺎﻫﯿﺖ درد ﭘﯿﻮﺳﺘﻪ، ﻣﯿﺰان درد ﺷﺪﯾﺪ، ﻣﻌﻤﻮﻻً ﺑﺪون اﻧﺘﺸﺎر
و ﺑﺎ ﻏﺬا ﺧﻮردن ﺗﺸﺪﯾﺪ و ﻋﺪم ﭘﺎﺳﺦ ﺑﻪ ﻣﺴﮑﻦﻫﺎ و ﺑﯿﺸﺘﺮﯾﻦ ﻫﻤﺮاﻫﯽ ﺑﺎ ﯾﺒﻮﺳﺖ را داﺷﺖ.
ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: درد ﺷﮑﻢ ﺑﯿﻤﺎران دﭼﺎر ﻣﺴﻤﻮﻣﯿﺖ ﺑﺎ ﺳﺮب اﮐﺜﺮاً در ﻧﺎﺣﯿﻪ ﭘﺮي اﻣﺒﻠﯿﮑﺎل ﺑﺎ ﻣﺎﻫﯿﺖ ﻣﺒﻬﻢ و ﭘﯿﻮﺳﺘﻪ ﻣﻌﻤﻮﻻً ﺑﺪون اﻧﺘﺸﺎر ﺑﻪ ﺟﺎﯾﯽ و ﺑﺎ ﺗﺸﺪﯾﺪ ﺑﻪ دﻧﺒﺎل ﻣﺼﺮف ﻏﺬا ﮐﻪ در اﮐﺜﺮﯾﺖ ﻣﻮارد ﺑﻪ ﻣﺴﮑﻦ ﺟﻮاب ﻧﻤﯽدﻫﺪ و ﺑﯿﺸﺘﺮﯾﻦ ﻫﻤﺮاﻫﯽ را ﺑﻪ ﺗﺮﺗﯿﺐ ﺑﺎ ﯾﺒﻮﺳﺖ، ﺑﯽاﺷﺘﻬﺎﯾﯽ، ﻧﻔﺦ، ﺗﻬﻮع و اﺳﺘﻔﺮاغ دارد.
چكيده لاتين :
Introduction & Objective: Each toxic agent results in unique presentations, depending on what
neurophysiological changes occur following exposure. Lead poisoning can lead to various signs and
symptoms. The aim of this study was to evaluate the abdominal pain characteristics of patients with lead
poisoning referred to Loghman Hakim Hospital in Tehran during 2016-2017.
Materials & Methods: All patients with lead poisoning were referred to Loghman Hakim Hospital
in Tehran from April 2016 to September 2017 undergoing surgical consultation Were Evaluated.
Information was recorded in a researcher-designed questionnaire. The questionnaire included demographic
information (age, sex, education, occupation) history of previous illness, history of addiction (type of
substance, drug use method, duration of drug use), abdominal examination, blood lead level, hemoglobin,
and results of paraclinical measures Plain abdominal geraphy. Data was analyzed using SPSS 16 soft ware.
P value less than 0.05 was considered significant.
Results: A total of 200 patients were diagnosed with lead poisoning based on history and serum lead
levels were evaluated. Of these, 184 were males (92%) and 16 were females (8%). The mean age of the
patients was 48 ± 4.5 (mean ± SD). Abdominal pain was more common in peri-umbelical, the nature of
pain was severe, usually without radiation, exacerbation with eating, non-response to analgesics and the
most associated with constipation.
Conclusions: Abdominal pain was more common in peri-umbelical, the nature of pain was severe,
usually without radiation, exacerbation with eating, non-response to analgesics and the most associated
with constipation.
