2013年北戴河儿童海蜇蜇伤暴发的流行病学分析  

Epidemiology of jellyfish stings on children in Beidaihe district in 2013

作　　者：张琪[1] 刘建丽[1] 康晓华[1] 闻卓岩 牛莉[1] 吴庆红[1] 

机构地区：[1]河北省秦皇岛市北戴河医院儿内科,河北秦皇岛066100

出　　处：《现代预防医学》2015年第8期1419-1421,1425,共4页Modern Preventive Medicine

基　　金：2013年河北省科技计划自筹经费项目(132777227)

摘　　要：目的分析2013年北戴河儿童海蜇蜇伤暴发的流行病学特点,探讨儿童海蜇蜇伤临床特点、治疗预后及预防措施。方法对2013年7月18日-8月19日于北戴河医院儿科诊治的654例海蜇蜇伤患儿的病例资料进行回顾性研究,分析患儿的性别、年龄、蜇伤部位、蜇伤程度及治疗预后等流行病学特征。结果 654例患儿中男女发病率无差异。4-12岁为高发年龄。蜇伤面积〈10%者522例（79.82%）,≥20%者86例（13.15%）。蜇伤部位主要在小腿以下455例（69.57%）,其次为上肢149例（22.78%）。391例局部用药轻症患者,首次正确处理组症状、体征消退时间明显短于处理不当组（t=20.51和21.51,P〈0.01）;正确处理组出现皮下水肿和/或水疱和/或瘀斑16例（5.94%）少于处理不当组（24例,19.67%）（χ^2=17.21,P〈0.01）。654例中首次正确处理组治愈时间明显短于处理不当组（χ^2=22.45,P〈0.01）。绝大多数病例3-10 d皮损恢复,伴严重并发症者少见,但可危及生命。海蜇皮炎复发者65例（9.94%）,复发高峰在第2-4周47例（72.31%）,诱因明确者32例（49.23%）,饮食是导致复发第1位诱因占75.00%。结论海蜇蜇伤是夏季海滨浴场造成儿童身心危害的主要原因之一,及时正确处理治疗尤为重要,预后相对较好,严重并发症致死率高。应采取积极有效的防护与安全教育,及时规范诊疗与生活饮食指导可促进康复、减少复发、降低恶性事件的发生。Objective The aim of this study was to analyze the epidemiology of jellyfish stings on children in Beidaihe district, and compare the clinical characteristics, treatment and preventive strategies. Methods Six hundred and fifty-four cases of children stung by jellyfish in the period from 18 thJun to 19 thAug recorded in Beidaihe hospital were analyzed based on gender, age, sting site,harmful degree, and treatment outcome. Results The majority of patients were from 4 to 15 years old. And there was no difference between genders. There were 522（79.82%） patients with harmed skin for less than 10% of the body. Eighty-six（13.15%） patients with harmed skin for larger than 20% of the body. Four hundred and fifty-five patients（69.57%） were stung at lower limbs. One hundred and forty-nine patients（22.78%） were stung at upper limbs. The symptoms and signs of 391 patients with exactitude therapy were subsided quicker than the patients without exactitude therapy（t=20.51 and 21.51, P〈0.01）. Cutaneous dropsy or/and blister or/and ecchymosis took place in 16 patients（5.94%） with exactitude therapy. However, 24 patients（19.67%） without exactitude therapy had these sicken（χ^2=17.21, P〈0.01）. Healing time of 654 patients with exactitude therapy were shorter than that of the patients without exactitude therapy（χ^2=22.45, P〈0.01）. Most of the injuries on the skin were recovered after 3 to 10 days therapy. Complications that risk to life occurred in a few patients. Jellyfish dermatitis occurred in 65 patients（9.94%）, and the highest frequency（47 patients 72.31%） was in the period of from two to four weeks after the sting. 49.23%（32 patients） of the dermatitis patients showed remote causes and major in diet（75.00%）. Conclusion Jellyfish sting was one of the injuries to children at the beach in summer. Sting injuries were easy to recovery. However, complications were risk for life. It is suggested that effective protection should be equipped. Efficacious treatment and diet could

关 键 词：海蜇蜇伤 儿童 流行病学 

分 类 号：R181.2[医药卫生—流行病学]