一宗黄蜂蜇伤57例临床分析

目的探讨不同毒量黄蜂蜇伤后各器官功能损害发生率及损害程度。方法根据蜂蜇伤量将57例黄蜂蜇伤患者分为2组,A组31例(<5刺),B组26例(≥5刺)。检测黄蜂蜇伤后患者血红蛋白、肝肾功能、心肌酶谱的变化,观察其器官功能损害的发生率。结果 A组和B组贫血分别为1例和6例,神经系统损害分别为0例和5例,肾脏损害分别为1例和12例,肝脏损害分别为1例和11例,心肌损害分别为0例和11例,2组差异均有统计学意义(均P<0.05);血清肌酐分别为(103±45)μmmol/L和(327±455)μmmol/L,2组差异无统计学意义(P>0.05);血红蛋白分别为(120±15)g/L和(95±34)g/L,肌酸激酶分别为(60±41)IU/L和(17659±29699)IU/L,肌酸激酶同工酶分别为(26±24)U/L和(833±1053)U/L,天冬氨酸转移酶分别为(36±21)U/L和(457±479)U/L,2组差异均有统计学意义(均P<0.05)。结论黄蜂蜇伤可引起肝、肾、心、脑、血液多系统损害。蜂蜇伤毒量大者,器官功能损害发生率增高,损害程度加重。

Clinical study of 57 cases stung by wasps

Objective To study the prevalence of organ dysfunctions and the extent of organ damages in patients stung by wasps.Methods We recruited 57 cases stung by wasps and divided them into two groups based on the number of stings,group A with 5 stings（n=31） and group B with ≥5 stings（n=26）.Their hemoglobin,liver function,renal function,and myocardial enzymes were measured,and the symptoms of organ dysfunctions were observed.Result In group A and group B,anemia was found in one case and 6 cases,neurological symptoms were detected in 0 case and 5 cases,renal damages in 1 case and 12 cases,liver dysfunctions in one case and 11 cases,myocardial injuries in 0 case and 11 cases,respectively;hemoglobin was（120±15）g/L and（95±34）g/L,CK was（60±41）IU/L and（17659±29699）IU/L,CK-MB（26±24）IU/L and（833±1053）U/L,and AST（36±21）U/L and 1U/L,respectively.All of the above parameters are statistically significant（P0.05） between the 2 groups.Serum creatinine was（103±45）μmol/L and（327±455）μmol/L in group A and group B,respectively,without statistical significance（P0.05） between the 2 groups.Conclusion Stings by wasps can induce multiple organ dysfunctions involving liver,kidney,nervous system and hematological system.Patients subjected to more wasp stings are prone to have severer extent of multiple organ dysfunctions.