重症蜂蛰伤临床特征及其预后影响因素分析

Analysis of Clinical characteristics and prognostic factors of severebee sting

目的分析重症蜂蛰伤的临床特征及其预后的高危因素,为临床提供更好的治疗决策。方法选择2017年10月-2019年10月安徽省立医院重症蜂蛰伤86例,按预后分为两组,痊愈组52例,遗留有器官异常或死亡组34例,收集两组临床资料和实验室指标。结果痊愈组与遗留有器官功能异常或死亡组在性别、年龄、高血压病和糖尿病等既往史,以及就诊时间和血液净化方式,PLT、APTT上差异均无统计学意义(P>0.05);在首次血液净化时间、Cr、BUN、PT、TB、AST/ALT上差异有统计学意义(P<0.05)。进一步多因素logistic回归发现,PT、TB、AST/ALT是重症蜂蛰伤预后的高危因素。结论PT、TB、AST/ALT指标升高是重症蜂蛰伤预后不良指标,早期血液净化治疗可能保护脏器功能。

Purpose To Analysis of the clinical characteristics and prognosis of severe bee sting,so as to provide bettertreatment decisions for clinical practice.Methods 86 cases of severe bee sting in Anhui provincial hospital from Octo-ber 2017 to October 2019 were selected.According to the prognosis,they were divided into two groups,52 cases in therecovery group and 34 cases in the left organ abnormality or death group.The clinical data and laboratory indexes ofthe two groups were collected.Results There was no significant difference in the past medical history of hypertensionand diabetes,age,gender PLT and APTT between the cured group and the left group(P>0.05);Time of first blood purifi-cation,Cr,BUN,PT.TB,AST/ALT were significant differences between recovery group and the left organ abnormalityor death group(P<0.05).Multivariate logistic regression showed that PT.TB and AST/ALT were the high risk factorsfor the prognosis of severe bee sting.Conclusion PT,TB and AST/ALT are the poor prognosis indexes of severe beesting,early blood purification treatment may protect organ function.