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目的:探讨蜂蛰伤致多器官功能障碍综合征(MODS)的危险因素,为临床上重症蜂蛰伤的防治提供帮助。方法:回顾分析我院2008~2015年间183例蜂蛰伤患者的临床资料,分为MODS组(51例)和非MODS组(132例),进行相关因素分析。结果:单因素分析结果显示MODS组患者蜂蛰伤后就诊时间、伤口数量、APACHEⅡ评分、白细胞计数、肌酸激酶水平明显高于非MODS组(P<0.05);MODS组患者血红蛋白、白蛋白水平低于非MODS组(P<0.05);非条件多因素Logistic回归分析结果显示蜂蛰伤伤口数量多,APACHEⅡ评分高,高白细胞计数,高肌酸激酶水平是蜂蛰伤并发MODS的独立危险因素;MODS组病死率高于非MODS组(P<0.01)。结论:伤口数量多、APACHEⅡ评分高、高白细胞计数、高肌酸激酶水平是蜂蛰伤并发MODS的独立危险因素。应早期对这些因素进行监测并采取及时有效的控制措施,防止病情的恶化和MODS的发生,改善患者的预后。
Objective: To investigate the risk factors of multiple organ dysfunction syndrome (MODS) caused by bee sting injury and to provide help for the prevention and treatment of severe bee stings in clinics. Methods: The clinical data of 183 cases of bee sting in our hospital from 2008 to 2015 were retrospectively analyzed. The data were divided into MODS group (n = 51) and non-MODS group (n = 132), and the related factors were analyzed. Results: The results of univariate analysis showed that the time of consultation, the number of wounds, APACHEⅡscore, leukocyte count and creatine kinase in MODS group were significantly higher than those in non-MODS group (P <0.05). The levels of hemoglobin and albumin (P <0.05). Logistic regression analysis showed that more stings of bee stings, higher APACHEⅡscore, high white blood cell count and high creatine kinase levels were independent risk factors for MODS in bee stings The mortality of MODS group was higher than that of non-MODS group (P <0.01). Conclusion: The number of wounds, high APACHEⅡ score, high WBC count and high creatine kinase level are independent risk factors for MODS in bee stings. These factors should be monitored early and take timely and effective control measures to prevent the deterioration of the disease and the occurrence of MODS to improve the prognosis of patients.