全血白细胞计数对黄蜂蜇伤死亡的预测价值(1)
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[摘要] 目的 探讨黄蜂蜇伤病情、死亡率与全血白细胞(WBC)之间的关系。 方法 分析广西宜州市3所医院57例蜂蜇伤住院患者病情、死亡率与血白细胞之间的关系。比较死亡组与非死亡组间的临床参数包括全血WBC计数的差异。 结果 11例(19.3%)患者死亡。死亡组的入院后首次全血WBC计数明显增高(P < 0.01)。 结论 黄蜂蜇伤患者入院后首次全血WBC的计数可作为评价病情轻重、预测死亡的重要指标。
[关键词] 黄蜂；蜇伤；白细胞
[中图分类号] R595.8 [文献标识码] B [文章编号] 1673-9701(2012)06-0049-02
The value of the white blood cell count in the prediction of the death by wasp stings
LUO Gang1 CHEN Yangkun2 LUO Jianshe3 LIU Caisu1
1.Emergency Department, the First People's Hospital of Hechi City in Guangxi Zhuang Autonomous Region, Yizhou 546300, China; 2.Department of Neurology, Dongguan City People's Hospital in Guangdong Province, Dongguan 523000, China：3.Emergency Department, Yizhou People's Hospital in Guangxi Zhuang Autonomous Region, Yizhou 546300, China
[Abstract] Objective To Investigate the relationship between white blood cell (WBC) count and the severity and mortality of wasp stings. Methods Fifty-seven patients of wasp stings from three hospitals from the city of Yizhou were retrospectively collected. All of the patients were divided into two groups in terms of death and non-death. Clinical features including WBC count were compared between the two groups. Results Eleven (19.3%) patients were dead. WBC count was significantly higher in the death group than in the non-death group (P < 0.05). Conclusion WBC count is an important indicator of the severity of wasp stings and predicts mortality.
[Key words] Wasps; Stings; Leukocytes
黄蜂也称胡蜂，胡蜂属于昆虫纲膜翅目细腰亚目胡蜂总科, 它主要包括胡蜂科、马蜂科、蜾赢科等11个类群[1]。蜂蜇伤以秋季较为常见[2]，发病高峰在每年9、10月份。黄蜂蜂体大，毒性强，群蜂蜇伤死亡率高[3]，越来越受到人们重视，如何对病情、预后进行快速、准确地评估，对指导治疗具有十分重要的意义。
1 资料与方法
1.1 一般资料
所选病例为2000年7月～2010年12月我市3所医院即河池市第一人民医院、宜州市人民医院和宜州市中医院黄蜂蜇伤住院的57例患者，男41 例,女16例,年龄3～83岁，平均(33.9±2.8)岁。死亡11例，死亡率19.3%。
1.2 临床表现
57例均出现蜇伤局部红、肿、痛。23例出现恶心、呕吐，6例出现局部或全身皮疹、风团等过敏反应，其中1例出现过敏性休克，13例出现解浓茶样尿等溶血反应。12例出现巩膜黄染。
1.3 实验室检查
7例出现心肌酶升高，肌酸激酶同工酶CK-MB(42～511)U/L；肝损害13例，总胆红素TBil(30.39～398.96) μmol/L、丙氨酸氨基转移酶ALT(101～1165)U/L；肾损害11例，血清肌酐Cr(153.1～1686)μmol/L, 高钾血症4例，血清钾K+(5.65～6.88)mmol/L，低钠血症5例，血清钠Na+(102.9～129.1)mmol/L。血白细胞(WBC)值为入院后第1次化验血常规的结果 ......
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