黔北某三甲医院胡蜂蛰伤348例临床特点分析

The clinical characteristics of Wasp stings in 348 cases

目的通过收集胡蜂蛰伤住院治疗患者的临床资料,分析其临床特点,以期为蜂蛰伤的预防及诊疗提供参考依据。方法采用回顾性研究方法,选择2016年1月至2019年3月黔北某三甲医院因蜂蛰伤住院治疗的348例患者为研究对象。收集患者的一般资料,入院24h内的实验室检查结果,治疗方法及预后转归情况。采用卡方检验、Fisher确切概率法、独立样本t检验,单因素方差分析及Sperman相关性分析,探索患者就诊时间窗、实验室检查结果及治疗方法与患者预后的关联性。结果①蜂蛰伤患者年龄与ICU住院时间及总住院时间正相关(P<0.05),患者受伤至就诊平均时间越长,ICU住院率越高、ICU住院时间及总住院时间越长(P<0.05);②入住ICU患者及死亡患者的生化指标(ALT、AST、Scr、APTT、CK)明显异常(P<0.05),达危急值项目越多,患者ICU住院率,死亡率越高(P<0.05),ICU住院时间及总住院时间越长(P<0.05);③重症蜂蜇伤患者,住院期间进行血液净化治疗者生存率更高(P<0.05)。结论蜂蛰伤患者高发于农村地区,蜂蛰伤患者伤后至就诊时间窗与ICU住院率、ICU住院时间及总住院时间相关,交通不便以及就医意识不足。生化指标危急值水平与ICU住院率、死亡率及病程时间直接相关。积极行血液净化治疗可提高重症蜂蛰伤患者生存率。

Objective In recent years,the incidents of wasp stinging have became more frequently,causing serious consequences,and have gradually become a problem of public health.We aimed to analyze the patients’clinical characteristics for providing a reference to the prevention and diagnosis of wasp stings.Methods A retrospective study of 348 patients hospitalized for wasp stings from the Affiliated Hospital of Zunyi Medical University from January 2016 to March 2019 were selected as study subjects.Collecting general information of patients,laboratory test results within 24 hours of admission,treatment methods and prognostic outcomes.Chi-square test,Fisher exact probability method,independent sample t-test,one-way analysis of variance and Spearman correlation analysis were used to explore the correlation between patient visit time window,laboratory test results and treatment methods and prognosis.Results 1)The age of patients with wasp stings was positively correlated with the length of stay in ICU and total length of hospital stay(P<0.05).The longer the average time from wasp stings to visit,the higher the rate of ICU hospitalization,the longer ICU stay,and the longer the total length of hospital stay(P<0.05);2)The biochemical indicators,which include AST,ALT,APTT,Scr,CK in patients admitted to ICU and those who died,were significantly abnormal(P<0.05).The more critical value abnormalities,the higher the patient's ICU hospitalization rate and mortality(P<0.05),the longer the time of ICU stay and total hospitalization(P<0.05);3)Patients with severe wasp stings received blood purification treatment during hospitalization had higher survival rate(P<0.05).Conclusion Patients with wasp stings are more common in rural areas.The time window from the injury to the consultation of patients with wasp stings is related to the ICU hospitalization rate,time,and total hospital stay.Inconvenience of transportation and insufficient medical awareness are concerned.The critical values of biochemical indicators are directly related to the ICU hospitalization rate,mortality and duration of illness.Active blood purification treatment can improve the survival rate of patients with severe wasp stings.