蜂蜇伤中毒146例临床回顾分析

目的：分析蜂蜇伤中毒的临床特征、治疗、转归，为正确防治蜂蜇伤中毒、提高抢救成功率提供参考。方法选取1997年1月~2013年12月在湖北省竹山县人民医院及十堰市人民医院就诊的蜂蜇伤中毒患者146例，对发病时间、蜇伤针数、临床表现、辅助检查、治疗方案及预后、转归等临床资料进行回顾性分析。结果①蜂蜇伤中毒发病具有明显的季节性，主要集中在9~10月，占56.16%；②蜂蜇伤中毒的临床表现复杂多样，可累及全身多个器官，易出现多器官功能不全，重要脏器损害发生率从高到低依次为肝、心、肾；③蜜蜂组、胡蜂组和大黄蜂组过敏症状的发生率差异无统计学意义（P ﹥0.05），胡蜂组和大黄蜂组头晕头痛、心肌损害、肝功能异常、肾功能不全、多器官损害的发生率高于蜜蜂组（P ﹤0.05）；④血液透析组病死率低于非血液透析组（P ﹤0.05）。结论蜂蜇伤中毒抢救成功的关键：①早期积极有效的抗过敏、抗休克治疗；②早期血液透析治疗；③加强多脏器功能保护。

Retrospective Analysis of 146 Patients with Bee Sting Intoxication

Objective To analyze clinical features,treatment and prognosis of bee sting intoxication in order to provide references for preventing it and improving rescue rate. Methods 146 patients with bee sting intoxication in Zhushan People′s Hospital and Shiyan People′s Hospital from Jan. 1997 to Dec. 2013 were reviewed. Retrospective a-nalysis was performed with the following indicators：onset time,number of stings,clinical manifestations,auxiliary ex-amination,therapeutic regimens and prognosis. Results ①Bee sting intoxication occurred mainly in Sep. and Oct. , accounting for 56. 16% . ②Clinical manifestations were complex. Multiple organs could be impaired and it was prone to induce multiple organ dysfunction syndromes. The incidences of organ lesions from high to low were liver,heart and kidney. ③There was no significant difference in the incidence of allergy symptoms among bee group,wasp group and hornet group（P ﹥ 0. 05）. The incidences of dizziness,headache,myocardial damage,liver dysfunction,renal insuffi-ciency and multiple organs impairment were higher in wasp group and hornet group than that in bee group（ P ﹤0. 05）. ④Mortality in hemodialysis group was significantly lower than that in non - hemodialysis group（P ﹤ 0. 05）. Conclusion To succeed in salvaging bee sting intoxication,it is crucial to do the following：①early and effectively antiallergic and antishock treatment;②early hemodialysis treatment;③reinforce the protection of multiple organs.