926例蜂蛰伤的回顾性分析

The Retrospective Analysis of 926 Cases of Bee Sting

目的分析蜂蛰伤流行病学资料及临床特征,为预防及诊治提供科学依据。方法回顾性分析四川大学华西医院急诊科2009至2013年收治的926例蜂蛰伤病例资料,对其流行病学特点、临床表现、实验室检查结果及预后进行描述性统计分析。结果 926例病例中男性453例,女性473例;平均年龄（37.4±18.4）岁;黄蜂蛰伤325例,蜜蜂蛰伤111例,不明蜂类蛰伤490例;蛰伤部位以头面颈部最常见（发生率52.16%）;各月份均有蜂蛰伤病例,但主要集中在7~11月,占80.89%;一天中发生于12∶00~18∶00时间段的锋蛰伤最多（531例）,其次为6∶00~12∶00时间段（212例）,18∶00~次日6∶00时间段最少（183例）。每名患者平均有（2±1）项伴随症状,局部疼痛（77.32%）、红肿（74.73%）、瘙痒（29.16%）为前3位症状;实验室检查以中性粒细胞百分比升高（19.98%）、白细胞计数升高（19.65%）、尿素升高（18.03%）以及门冬氨酸氨基转移酶升高（10.04%）最常见;12.20%患者需住院治疗,其中死亡3例,病死率0.32%。结论蜂蛰伤7~11月易发,蛰伤部位以头面颈部多见,治疗上主要关注过敏反应及肾、肝等靶器官功能损害,以减少病死率。

Objective： To analyze epidemiological data and clinical characteristics of bee sting to provide scien- tific basis for prevention and treatment. Method： 926 bee sting cases were retrospectively analyzed in emergency department of West China Hospital of SiChuan University from 2009 to 2013 ,as well as descriptive statistics of epidemiological characteristics, clinical manifestation,laboratory examination results and prognosis. Results： Data of 926 cases,453 male and 473 female,with an average age of （37.4＋18.4）. The number of Wasp,honeybee and unknown bee were 325,111 and 490 respectively. The cranioface and neck were the most common position of sting （incidence rate 52.16% ）. Each month had bee sting injury cases, mainly from July to November, accounting for 80.89%. The bee stings occurred mostly in time quantum of 12：00-18：00 （531 cases）,followed by 6：00-12：00 （212 cases）, and the least of 18：00~6：00 of the next day. Each patient had an average of （2＋1） symptoms,among which, local pain （77.32%）, red and swellon （74.73%）, pruritus （29.16% ） were the first three symptoms. The most common increasing laboratory examinations were N% （19.98%）,WBC （19.65%）,UREA （18.03%）,AST （10.04%）. 12.2% patients required hospitalization,3 of whom died,and the mortality was 0.32%. Conclusions： Bee sting injury occurs much from July to November. The most common positions of sting are cranioface and neck. The treatment should be focused on allergic reaction and target organs damage, such as kidney and liver, to reduce the mortality.