摘要
目的分析胡蜂蜇伤患者并发全身炎症反应综合征(SIRS)的临床特征及其对预后的影响。方法采用回顾性病例对照研究,选取2014—2023年汉中市中心医院收治的393例胡蜂蜇伤患者为研究对象,其中SIRS组117例、非SIRS组276例;单因素分析采用t检验、Mann-Whitney U检验、χ^(2)检验或精确F检验,多因素logistic回归分析胡蜂蜇伤患者发生SIRS的危险因素。结果393例蜂蜇伤患者中发生SIRS 117例,占29.78%;在SIRS的4项构成因素中,以WBC升高最常见,其次为呼吸和心率加快,未见体温异常因素。单因素分析显示蜂蜇伤创面≥10处、皮肤溃疡、消化及呼吸系统出现过敏反应在SIRS组和非SIRS组间的差异具有统计学意义(P<0.05);蜂蜇伤创面≥10处、呼吸系统过敏反应是导致蜂蜇伤并发SIRS的独立危险因素;SIRS组患者死亡率(16.24%,19/117)、多器官功能障碍综合征(MODS)发生率(26.50%,31/117)均显著高于非SIRS组(2.90%,10.87%);两组在急性脏器功能损伤相关指标间的差异亦具有统计学意义(P<0.05)。结论SIRS在胡蜂蜇伤患者中发生比例较高,对患者预后具有不利影响;蜂蜇伤创面数量和出现呼吸系统过敏反应是导致蜂蜇伤患者SIRS的独立危险因素。
Objective To analyze the clinical characteristics of systemic inflammatory response syndrome(SIRS)in patients with wasp stings and its impact on prognosis.Methods A retrospective case-control study was conducted,selecting 393 patients with wasp stings admitted to Hanzhong Central Hospital from 2014 to 2023 as research subjects,including 117 in the SIRS group and 276 in the non-SIRS group.Univariate analysis was performed using t-test,Mann-Whitney U test,chi-square test or exact F-test,and the multivariate logistic regression was used to analyze the risk factors for SIRS in patients with wasp stings.Results The results showed that among the 393 wasp stung patients,there were 117 cases of SIRS,accounting for 29.78%;among the four components of SIRS,elevated leukocytes was the most common,followed by increased breathing and heart rate,but no abnormal body temperature was observed.In the univariate analysis,there were some statistically significant differences between SIRS group and non-SIRS group in terms of sting wounds≥10,skin ulcers,and allergic reactions in digestive and respiratory systems;sting wounds≥10 and allergic reaction of respiratory system were the independent risk factors for bee sting induced SIRS.Furthermore,the mortality rate(16.24%,19/117)and the incidence of multiple organ dysfunction syndrome(MODS)in SIRS group were significantly higher than those in non SIRS group(2.90%,10.87%),and the difference in indicators related to acute organ dysfunction between the two groups was also statistically significant(P<0.05).Conclusion This study suggested that SIRS had a high incidence rate in wasp stung patients,which had obviously negative impact on prognosis of the patients;meanwhile,the number of wounds and occurrence of respiratory allergic reaction were the independent risk factors for SIRS in patients with wasp stings.
作者
王兰
刘海霞
刘晶晶
汪砫
王新芳
高亚萍
王铎
李怡玲
刘波
郭新成
WANG Lan;LIU Haixia;LIU Jingjing;WANG Zhu;WANG Xinfang;GAO Yaping;WANG Duo;LI Yiling;LIU Bo;GUO Xincheng(Department of Critical Care Medicine,Hanzhong Municipal Central Hospital,Hanzhong,Shaanxi 723000,China)
出处
《中国工业医学杂志》
2025年第1期14-18,共5页
Chinese Journal of Industrial Medicine
基金
汉中市中心医院院级基金(YK2312)。
