蜂蜇伤中毒致多脏器衰竭临床治疗对策研究  

Study on clinical treatment of multiple-organ failure caused by bee-sting poisoning

作　　者：柳胜强 黎小娟 LIU Sheng-qiang;LI Xiao-juan(Department of Emergency Medicine,Zhongxian County People's Hospital,Chongqing 404300,China)

机构地区：[1]重庆市忠县人民医院急诊医学科,404300

出　　处：《中国实用医药》2024年第2期64-67,共4页China Practical Medicine

摘　　要：目的 研究蜂蜇伤中毒致多脏器衰竭的临床治疗对策及效果。方法 回顾性分析80例蜂蜇伤中毒致多脏器衰竭患者的临床资料,随机分为双治组与单治组,每组40例。双治组患者行血液灌流与甲泼尼龙联合治疗,单治组患者行血液灌流治疗。比较两组患者治疗效果、肝功能指标[总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、血肌酐(SCr)]及生化指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、白细胞计数(WBC)、血小板计数(PLT)、血红蛋白(Hb)]。结果 双治组蜂蜇伤中毒致多脏器衰竭患者治疗总有效率95.00%高于单治组的77.50%,差异有统计学意义(P<0.05)。治疗前,双治组及单治组蜂蜇伤中毒致多脏器衰竭患者的肝功能指标相近(P>0.05);治疗后,双治组及单治组蜂蜇伤中毒致多脏器衰竭患者的肝功能指标均有改善,双治组SCr(359.45±97.38)μmol/L、ALT(180.45±42.38)U/L、TBiL(30.38±10.67)μmol/L较单治组的(407.37±108.28)μmol/L、(281.37±53.28)U/L、(38.27±12.94)μmol/L更低,差异有统计学意义(P<0.05)。治疗前,双治组及单治组蜂蜇伤中毒致多脏器衰竭患者的生化指标相近(P>0.05);治疗后,双治组及单治组蜂蜇伤中毒致多脏器衰竭患者的生化指标均有改善,双治组CK(652.23±142.63)U/L、CK-MB(28.31±8.23)U/L、LDH(446.23±110.63)U/L、WBC(10.31±3.23)×10^(9)/L较单治组的(1182.35±265.47)U/L、(40.12±13.24)U/L、(816.35±180.47)U/L、(15.12±4.24)×10^(9)/L更低,PLT(88.23±15.63)×10^(9)/L、Hb(79.31±22.23)g/L较单治组的(77.35±15.47)×10^(9)/L、(68.12±21.24)g/L更高,差异有统计学意义(P<0.05)。结论 血液灌流与甲泼尼龙联合治疗蜂蜇伤中毒致多脏器衰竭的临床疗效更显著,值得临床广泛运用。Objective To study the clinical treatment strategy and effect of multiple-organ failure caused by bee-sting poisoning.Methods The clinical data of 80 patients with multiple-organ failure caused by bee-sting poisoning were retrospectively analyzed and randomly divided into dual-treatment group and single-treatment group,with 40 cases in each group.The patients in the dual-treatment group were treated with hemoperfusion and methylprednisolone,and the patients in the single-treatment group were treated with hemoperfusion.Both groups were compared in terms of therapeutic effect,liver function indexes[total bilirubin (TBiL),alanine aminotransferase (ALT),serum creatinine (SCr)]and biochemical indexes[creatine kinase (CK),creatine kinase isoenzyme (CK-MB),lactate dehydrogenase (LDH),white blood cell count (WBC),platelet count (PLT),hemoglobin (Hb)].Results The total effective rate of patients with multiple-organ failure caused by bee-sting poisoning in the dual-treatment group was 95.00%,which was higher than 77.50%in the single-treatment group and the difference was statistically significant (P<0.05).Before treatment,the liver function indexes of patients with multiple-organ failure caused by bee-sting poisoning were similar in dual-treatment group and singletreatment group (P>0.05).After treatment,the liver function indexes of patients with multiple-organ failure caused by bee-sting poisoning were improved in both the dual-treatment group and the single-treatment group;SCr of(359.45±97.38)μmol/L,ALT of (180.45±42.38) U/L,TBiL of (30.38±10.67)μmol/L in the dual-treatment group were lower than those of (407.37±108.28)μmol/L,(281.37±53.28) U/L,(38.27±12.94)μmol/L in the single-treatment group;the difference was statistically significant (P<0.05).Before treatment,the biochemical indexes of patients with multiple-organ failure caused by bee-sting poisoning were similar in dual-treatment group and single-treatment group (P>0.05).After treatment,the biochemical indexes of patients with multipleorgan failure caused

关 键 词：蜂蜇伤中毒 多脏器衰竭 血液灌流 甲泼尼龙 疗效 

分 类 号：R646[医药卫生—外科学]