蜂螫伤致115例患者多器官功能障碍的临床观察

Clinical observation on 115 patients with multiple organ dysfunction caused by wasp sting

目的探讨蜂螫伤致多器官功能障碍综合征(MODS)患者预后的影响因素。方法选择2002年7月至2011年9月该院收治的蜂螫伤患者96例为存活组,选取同期蜂螫伤患者治疗无效死亡的患者19例为死亡组,比较两组的临床资料。结果预后与年龄、螫伤部位及就诊时机有关(P<0.05)。年龄小于或等于12岁、>60岁患者死亡率均明显高于13～60岁患者(χ2=11.025,P<0.05;χ2=4.983,P<0.05);螫伤头颈部死亡率高于螫伤其他部位患者(χ2=9.361,P<0.05);随着就诊时机延长、预后越差(χ2=8.41,P<0.05)。存活组螫伤后72h时的血尿淀粉酶与死亡组比较,差异有统计学意义(P<0.05)。结论蜂螫伤致MODS患者的预后与年龄、螫伤部位、及时就诊等因素相关;血尿淀粉酶可作为了解蜂螫伤致MODS患者预后的生物学指标。

Objective To explore the factors influencing the prognosis of the patients with multiple organ dysfunction syndrome（MODS） caused by wasp sting.Methods From July 2002 to September 2011,96 patients with wasp sting were survived and selected as the survival group,and contemporaneous 19 patients died from MODS caused by wasp sting were selected as the death group.The clinical data were compared between the two groups.Results The prognosis was related with age,sting site and visiting hospital time（P0.05）.The mortality rate in age ≤ 12 years old and 60 years old was significantly higher than that in age 13-60 years old（χ2=11.025,P0.05;χ2=4.983,P0.05）.The mortality rate in the head and neck sting was higher than that in sting other sites by wasp（χ2=9.361,P0.05）.The prognosis was poorer with prolonging of visiting hospital time（χ2=8.41,P0.05）.Serum AMS and urine AMS at 72 h after wasp sting had statistical differences between the survival group and the death group（P0.05）.Conclusion The prognosis of the patients with MODS caused by wasp sting is related with age,sting sites and visiting hospital time.Serum and urine amylase might become the biological markers for estimating prognosis.