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目的:探讨群蜂蛰伤的临床特点,分析与病情严重程度及预后相关的实验室指标。方法:回顾2014~2015年我院ICU收治的24例群蜂蛰伤患者临床资料,包括各脏器损害情况、APACHEⅡ评分及血常规、凝血图、心肌酶谱、肝肾功能实验室检查结果,按照临床结局分为生存组和死亡组,比较各实验室指标的组间差异,同时分析各实验室指标与APACHEⅡ评分的相关性。结果:群蜂蛰伤后极易出现血液、心、肾、肝、肺、神经等多器官功能障碍,且以血液、心血管系统最易累及,6例因多器官功能衰竭死亡,死亡组患者肌酸激酶同工酶(CKMB)水平显著高于生存组(P<0.01),而CK-MB、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)与APACHEⅡ评分呈显著正相关(P<0.01)。结论:群蜂蛰伤极易出现多器官功能损害,CK-MB可作为评估群蜂蛰伤患者病情严重程度及预后的良好参考指标。
Objective: To investigate the clinical characteristics of sting in swarms and analyze the laboratory indexes related to the severity and prognosis of the swarms. Methods: The clinical data of 24 stinger wasps in ICU of our hospital from 2014 to 2015 were retrospectively reviewed, including the damage of each organ, APACHEⅡscore and blood routine, coagulation map, myocardial enzymes, liver and kidney function laboratory test results, According to the clinical outcome, the patients were divided into survival group and death group. The differences between the two groups were compared. At the same time, the correlation between each laboratory index and APACHEⅡscore was analyzed. Results: The stings of swarms were more likely to appear multiple organ dysfunction such as blood, heart, kidney, liver, lung and nerves. The blood and cardiovascular system were most easily involved, and 6 died of multiple organ failure. In the death group (CKMB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin There was a significant positive correlation between TBIL and APACHE Ⅱ scores (P <0.01). CONCLUSION: Multiple organ damage can occur easily when the wasps are stung, and CK-MB can be used as a good reference to evaluate the severity and prognosis of the wasps.