摘要
目的了解四川部分地区蜂螫伤相关过敏反应的发生情况、危险因素、诊治现状及其对预后的影响。方法回顾性分析四川省内不同地区9家医院2010年1月1日-2011年12月31日到急诊科就诊的387例蜂螫伤患者资料,采集资料包括患者一般信息、就诊时病情、就诊后接受治疗情况及至离院后1个月内的随访资料。采用非条件logistic逐步回归法分析蜂螫伤后过敏反应发生的危险因素;采用Fisher确切概率法分析发生过敏反应对患者死亡的影响。结果 387例蜂螫伤患者中,41例(10.6%)出现过敏反应,过敏患者的年龄高于未过敏组,差异有统计学意义(P<0.05)。非条件logistic回归分析显示年龄为患者蜂螫伤后发生过敏反应的独立危险因素[OR=0.983,95%CI(0.967,0.999),P=0.042]。41例发生过敏反应的患者就诊后均全身使用糖皮质激素,其中16例患者联用抗组胺类药物,无患者使用肾上腺素。16例发生全身性过敏反应的患者中,12例患者24 h内静脉补液量<1 000 m L。发生过敏反应的患者病死率(9.8%)高于未过敏者(1.4%),差异有统计学意义(P=0.009)。结论蜂螫伤过敏患者的病死率显著高于非过敏患者。年龄是蜂螫伤后发生过敏反应的独立危险因素。对蜂螫伤相关严重过敏反应的救治尚有待进一步规范。
Objective To identify the clinical features of and risk factors for allergic reaction to bee stings in Sichuan. Methods We retrospectively analyzed the clinical data of 387 patients with bee stings admitted to the Emergency Department of nine hospitals in S ichuan during January 1, 2010 to December 31, 2011, and evaluated the risk factors for bee sting anaphylaxis with logistic regression analysis, and explored the influence of anaphylaxis on death with Fisher exact probability method. Results Among the 387 patients with bee stings, 41 （10.6%） had allergic reactions. The age in patients from the anaphylaxis group was significantly older than those in the non-anaphylaxis group （P 〈 0.05）. Logistic regression analysis showed that age was an independent risk factor for allergic reaction in patients with bee stings [0R=0.983, 95%CI （0.967, 0.999）, P=0.042]. All the patients with allergic reactions were prescribed with systemic corticosteroids, and 16 were prescribed with antihistamine drugs, but no patients were prescribed with epinephrine. Among the 16 patients with systemic allergic reaction, 12 were given less than 1 000 mL intravenous rehydration per 24 h, 2 were given 1 000-3 000 mL intravenous rehydration, and only 2 were given more than 3 000 mL intravenous rehydration. The mortality of allergic patients was significantly higher than that of the non-allergic group （9.8% vs 1.4%, P 〈 0.05）. Conclusions The mortality of anaphylaxis patients is significantly higher than that of the non-anaphylaxis group. Age is an independent risk factor for allergic reactions to bee stings. Treatment of bee stings related to severe allergic reaction needs to be further standardized.
出处
《华西医学》
CAS
2015年第6期1019-1022,共4页
West China Medical Journal
基金
四川省科技厅应用技术研究与开发项目(2010SZ0097)~~
