摘要
目的:分析重症蜂蛰伤患者的临床特征和死亡危险因素。方法:收集2014年~2018年我院重症医学科收治的41例蜂蛰伤患者的临床资料,根据患者的最终结局,分为死亡组(12例)和存活组(29例),比较两组患者的年龄、性别、创面数和实验室检查指标等,多因素Logistic回归分析重症蜂蛰伤患者的死亡危险因素。结果:蜂蛰伤好发于8月~11月,平均年龄为58.29±16.34岁。与存活组比较,死亡组患者的平均年龄更大,肌酸磷酸激酶同工酶(CKMB)、谷草转氨酶(AST)、直接胆红素(DBIL)、乳酸脱氢酶(LDH)和α羟丁酸脱氢酶(αHBDH)的水平更高,差异均有统计学意义(均P<0.05)。两组患者的性别、胡蜂比例、创面数、蛰伤到治疗的时间、基础疾病情况、尿液异常比例、白细胞、血小板、肌酸激酶(CK)、总胆红素(TBIL)、尿素氮(BUN)和肌酐(Cr),差异均无统计学意义(均P>0.05)。多因素Logistic回归分析显示,年龄≥60岁(P=0.012,OR=1.683,95%CI=1.027~1.563)是重症蜂蛰伤患者死亡的独立危险因素。结论:重症蜂蛰伤患者预后较差,年龄可作为判断患者预后的重要指标。
Objective:To investigate the clinical characteristic and death risk factors in severe bee sting patients.Methods:The clinical data of 41 cases of severe bee sting in intensive care unit(ICU)of our hospital from 2014 to 2018 were retrospectively analyzed.All cases were divided into the death group(12 cases)and the survival group(29 cases)on the basis of prognosis.The indicators,including age,sex,wound number and laboratory indexs were analyzed.Multivariate logistic regression method was used to screen the death risk factor for bee stings.Results:Bee stings tended to occur from August to November,with an average age of58.29±16.34.Compared with the survival group,the average age of the patients in the death group was older,and the levels of creatine phosphokinase isoenzyme(CKMB),aspartate transaminase(AST),direct bilirubin(DBIL),lactate dehydrogenase(LDH)andαhydroxybutyrate dehydrogenase(α HBDH)were higher,all with statistically significant differences(All P<0.05).While there were no significant differences of gender,wasps ratio,wound numbers,time of stings to treatment,basic diseases,abnormal urine ratio,white blood cells,platelets creatine kinase(CK),total bilirubin(TBIL),blood urea nitrogen(BUN)and creatinine(Cr)between the two groups(All P>0.05).Multivariate logistic regression analysis indicated that age≥60 years(P=0.012,OR=1.683,95%CI=1.027 to 1.563)was an independent risk factor for death in patients with severe bee sting.Conclusion:The prognosis of patients with severe bee stings is poor,and age could be an important indicator to determine the prognosis of those patients.
作者
汪静
Wang Jing(Department of Emergency and Intensive Care Unit, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang 443003, China)
出处
《巴楚医学》
2019年第3期35-40,共6页
Bachu Medical Journal
基金
宜昌市卫生科研资助项目(No:A16-301-08)
