Clinical Features of Severe Wasp Sting Patients with Dominantly Toxic Reaction: Analysis of 1091 Cases
Clinical Features of Severe Wasp Sting Patients with Dominantly Toxic Reaction: Analysis of 1091 Cases
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DOI：
10.1371/journal.pone.0083164
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发表时间：
2013-12-31
期刊：
影响因子：
3.7
通讯作者：
Wang, Wei
中科院分区：
文献类型：
--
作者：
Xie, Cuihong;Xu, Shabei;Wang, Wei
背景：大量的黄蜂蜇伤被大大低估，并没有得到系统的研究。本研究的目的是确定严重黄蜂stings.Methods和调查结果的临床特点和治疗策略：一个多中心的回顾性研究进行了35家医院和医疗中心，包括12个三级保健医院和23个二级保健医院在湖北省，中国。对1091例住院黄蜂蜇伤患者的详细临床资料进行了调查。超过四分之三（76.9%）的病例有10次或以上的刺伤，患者的住院死亡率为5.1%。48名患者死于毒刺中毒后的器官损伤，6名患者死于过敏性休克。>10次蜇伤患者的住院病死率高于≥ 20次蜇伤和延迟入院（蜇伤后>= 4h）的患者。结论：我国多处黄蜂蜇伤患者多表现为毒液中毒反应和多器官功能障碍，而非过敏反应。阿基是马蜂蜇伤后出现中毒反应的突出临床表现。高肌酐水平、休克、少尿和贫血是死亡的危险因素。
Background: Massive wasp stings have been greatly underestimated and have not been systematically studied. The aim of this study was to identify the clinical features and treatment strategies of severe wasp stings.Methods and Findings: A multicenter retrospective study was undertaken in 35 hospitals and medical centers including 12 tertiary care hospitals and 23 secondary care hospitals in the Hubei Province, China. The detailed clinical data of 1091 hospitalized wasp sting patients were investigated. Over three-fourths (76.9%) of the cases had 10 or more stings and the in-hospital mortality of patients was 5.1%. Forty-eight patients died of organ injury following toxic reactions to the stings, whereas six died from anaphylactic shock. The in-hospital mortality in patients with >10 stings was higher than that of = 20 stings and delayed hospital admission of patients (>= 4 hours after sting).Conclusions: In China, most patients with multiple wasp stings presented with toxic reactions and multiple organ dysfunction caused by the venom rather than an anaphylactic reaction. AKI is the prominent clinical manifestation of wasp stings with toxic reaction. High creatinine levels, shock, oliguria, and anemia were risk factors for death.