蜂蛰伤致多器官功能障碍综合征危险因素分析

Risk factors of multiple organs dysfunction syndrome caused by wasp sting

目的：探讨蜂蛰伤致多器官功能障碍综合征（MODS）的危险因素,为临床上重症蜂蛰伤的防治提供帮助。方法：回顾分析我院2008～2015年间183例蜂蛰伤患者的临床资料,分为MODS组（51例）和非MODS组（132例）,进行相关因素分析。结果：单因素分析结果显示MODS组患者蜂蛰伤后就诊时间、伤口数量、APACHEⅡ评分、白细胞计数、肌酸激酶水平明显高于非MODS组（P〈0.05）;MODS组患者血红蛋白、白蛋白水平低于非MODS组（P〈0.05）;非条件多因素Logistic回归分析结果显示蜂蛰伤伤口数量多,APACHEⅡ评分高,高白细胞计数,高肌酸激酶水平是蜂蛰伤并发MODS的独立危险因素;MODS组病死率高于非MODS组（P〈0.01）。结论：伤口数量多、APACHEⅡ评分高、高白细胞计数、高肌酸激酶水平是蜂蛰伤并发MODS的独立危险因素。应早期对这些因素进行监测并采取及时有效的控制措施,防止病情的恶化和MODS的发生,改善患者的预后。

Objective：To investigate the risk factors of multiple organs dysfunction syndrome caused by wasp sting.Method：A retrospective analysis on the clinical data of 183 wasp sting patients from 2008 to 2015was conducted.The 183 patients were divided into MODS group（51cases）and non-MODS group（132cases）,and the relevant factors were analyzed.Result：The admission time,the number of sting,APACHEⅡ score,white blood cell count,the level of creatine kinase in MODS group were higher than those in non-MODS group（P〈0.05）;and the level of hemoglobin,albumin in MODS group were lower than those in non-MODS group（P〈0.05）;the non-conditional multivariate logistic regression analysis showed that the number of sting,high APACHEⅡ score,high white blood cell count,high creatine kinase levels were independent risk factors for patients complicated with MODS.The mortality of MODS group was higher than non-MODS group（P〈0.01）.Conclusion：The number of sting,high APACHEⅡ score,high white blood cell count,high creatine kinase levels were independent risk factors for wasp sting patients complicated with MODS.The risk factors should be monitored.We should take effective measures to avoid disease progress and complication by MODS.