摘要
目的分析马蜂蛰伤重症患者的临床资料,探讨蜂蛰伤的发病特点和规律,为蜂蛰伤的救治提供临床经验和方法。方法回顾性分析我院肾内科收治的24例马蜂蛰伤重症患者的病例资料,对基本资料、临床表现、生化结果、治疗及预后进行描述性统计分析。结果基本资料:患者急诊入院,各年龄段均有发生,多有野外劳作群蜂蛰伤史,以身体暴露部位蛰伤为主。存活、死亡两组患者的性别、年龄、就诊时间,差异无统计学意义(P>0.05),住院时间差异有统计学意义(P<0.05)。临床表现:患者除有局部疼痛红肿、酱油样尿、少尿外,还伴有不同程度的头晕、呕血或黑便、恶心、呕吐、过敏等症状。生化检查:血常规(WBC、中性粒细胞百分比、Hb、PLT)、凝血功能、肝肾功能(ALT、AST、尿素氮、肌酐)、肌酶(LDH、CK)等指标明显异常。治疗及预后:经血液滤过、透析、激素抗炎等综合治疗后,22例治愈,2例死亡。结论马蜂蛰伤重症患者,早期经血液滤过、透析、激素抗炎等综合治疗可获得较好的预后。
Objective The clinical data of patients with severe wasp stings were analyzed,and the characteristics and rules of wasp stings were discussed,so as to provide clinical experiences and methods for the treatment of wasp stings.Methods Retrospective analysis was performed on the case records of 24 patients with severe wasp stings admitted to the Department of Nephrology of our hospital,and descriptive statistical analysis was conducted on the basic data,clinical manifestations,biochemical results,treatment and prognosis.Results Basic information:the patients were admitted to the Emergency Department of hospital,this disease occurred in all age groups.Most of the patients had history of wasp stings when working in the field,mainly in the exposed parts of the body.There was no significant difference in the gender,age and treatment time between the survival group and death group(P>0.05),and the difference in the duration of hospitalization between two groups was statistically significant(P<0.05).Clinical manifestations:in addition to local pain and red swelling,soy sauce-colored urine and oliguria,patients also had various degree of symptoms of dizziness,hematemesis or black stool,nausea,vomiting and allergies.Biochemical examination:the indexes of blood routine examination(WBC,percentage of neutrophils,Hb,PLT),coagulation function,liver and kidney functions(ALT,AST,urea nitrogen,creatinine)and muscle enzymes(LDH,CK)were significantly abnormal.Treatment and prognosis:22 cases were cured and 2 cases died after comprehensive treatment including hemofiltration,dialysis and hormone anti-inflammation.Conclusion The patients with severe wasp stings can get a good prognosis after early comprehensive treatment such as hemofiltration,dialysis and hormone anti-inflammation.
作者
张世田
唐汉庆
林起庆
Zhang Shitian;Tang Hanqing;Lin Qiqing(Changle People’s Hospital,Changle 262400,Shandong,China;School of Basic Medicine,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;Department of Emergency,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)
出处
《右江民族医学院学报》
2020年第3期332-335,共4页
Journal of Youjiang Medical University for Nationalities
基金
广西百色市自筹课题(百科20183325)。
关键词
马蜂
蛰伤
重症
诊治经验
wasp
sting
severe case
diagnosis and treatment experiences
