马蜂蜇伤中毒老年患者器官功能障碍的临床观察

Clinical observation on organ dysfunction in the elderly after wasp sting

摘要:

目的 了解和掌握老年人马蜂蜇伤的临床特点和发病规律，以有效提高急性马蜂蜇伤的抢救成功率。方法 收集2009年1月至2013年12月竹山县人民医院收治的马蜂蜇伤病例共221例，根据年龄分为两组，老年组（年龄≥60岁）56例，非老年组（年龄＜60岁）165例，对两组患者多器官功能障碍、预后转归情况进行对比分析。结果 急性马蜂蜇伤，老年组器官功能障碍发生率依次为：肝脏55.36%，心血管32.14%，非老年组器官功能障碍发生率依次为：肝脏56.97%，心血管36.97%；老年组出现多器官功能障碍共有35例，发生率62.50%，非老年组共有94例，发生率56.97%，差异无统计学意义（P＞0.05）。多器官功能障碍死亡老年组2例，病死率5.71%，非老年组2例，病死率2.13%，差异无统计学意义（P＞0.05）。结论 本地区急性马蜂蜇伤中毒致器官功能障碍老年患者、非老年患者均以肝脏和心血管最多见；老年患者、非老年患者多器官功能障碍发生率差异无统计学意义，出现多器官功能障碍后病死率差异亦无统计学意义。

Abstract:

Objective To investigate the clinical characteristics and pathogenesis of wasp sting in the elderly in order to improve the rescue success rate. Methods Two hundreds and twenty-one patients suffering from acute wasp sting admitted in Zhushan County People’s Hospital from January 2009 to December 2013 were enrolled in this study, and assigned into different groups according to their ages, the elderly group (n＝56, ≥60 years old) and non-elderly group (n＝165, ＜60 years old). Their incidences of multiple organ dysfunction, prognosis and clinical outcomes were analyzed and compared. Results After acute wasp sting, the incidences of liver and cardiovascular dysfunction were 55.36% and 32.14%, respectively in elderly group, while in non-elderly group, the incidences were 56.97% and 36.97% respectively. There were 35 patients developing to multiple organ dysfunction syndrome (MODS) in elderly group, accounting for 62.50%, and 94 patients in non-elderly group (56.97%), but no significant difference was seen between the 2 groups (P＞0.05). The mortality was 62.50% in elderly group (2 cases) and 56.97% in non-elderly group (2 cases, P＞0.05). Conclusion The most commonly damaged organs are liver and cardiovascular system in either elderly or non-elderly patients following acute wasp sting. And, there is no obvious difference in the incidence of MODS and mortality between the 2 different aged groups.