摘要
目的探讨黄蜂蛰伤临床特点及黄蜂蛰伤患者发生急性肾损伤的危险因素,为预防及科学诊治提供依据。方法选取2015年11月至2018年11月于宝鸡市中心医院急诊科就诊的195例黄蜂蛰伤患者为研究对象,分析黄蜂蛰伤的流行病学特点;按就诊时是否发生急性肾损伤(AKI)分为AKI组和非AKI组,比较两组年龄、临床表现、化验指标、治疗方式和转归,Logistic回归分析AKI发生的危险因素。结果黄蜂蛰伤后AKI组较非AKI组平均年龄大,两组性别、受伤部位疼痛无统计学差异(P>0.05),AKI组出现皮疹、休克、头痛血尿等症状明显高于非AKI组(P<0.05);两组血白细胞、尿蛋白、尿红细胞、内源性凝血(APTT)、D二聚体、心肌酶(LDH)具有统计学差异(P<0.05)。黄蜂蛰伤AKI风险因素的Logistic回归模型显示,APTT延长可能是独立危险因素。结论黄蜂蛰伤后应密切监测凝血功能,对APTT延长者须警惕急性肾损伤的发生。
ObjectiveTo investigate the clinical characteristics of wasp stings,and to explore the risk factors of acute kidney injury(AKI)caused by wasp stings.MethodsA total of 195 cases of wasp stings admitted to the Emergency Department of Baoji Central Hospital during Nov.2015 and Nov.2018 were involved.The patients were divided into AKI group and non-AKI group.The patients’age,clinical manifestations,laboratory indexes,treatment methods and therapeutic effects were compared between the two groups.The risk factors of AKI were analyzed with Logistic regression model.ResultsThe patients in the AKI group were older than patients in the non-AKI group,while there were no statistically significant differences in gender and pain at the injured site between the two groups(P>0.05).The incidences of rash,shock,headache and hematuria were significantly higher in the AKI group than in the non-AKI group(P<0.05).There were statistically significant differences in leukocyte,urine protein,urine erythrocyte,endogenous coagulation(APTT),D dimer and myocardial enzyme(LDH)between the two groups(P<0.05).Logistic regression model showed that APTT prolongation might be an independent risk factor of AKI.ConclusionIn case of wasp stings,APTT should be closely monitored.Patients with prolonged APTT may have risk of AKI.
作者
张琼
王彩凤
梁哲
ZHANG Qiong;WANG Cai-feng;LIANG Zhe(Baoji Central Hospital,Baoji 721008;Department of Emergency,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《现代泌尿外科杂志》
CAS
2019年第11期944-947,共4页
Journal of Modern Urology
关键词
黄蜂蛰伤
流行病学
急性肾损伤
危险因素
wasp sting
epidemiology
acute kidney injury(AKI)
risk factors
