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华西医学  2015 

蜂螫伤相关过敏反应患者的临床特征及其危险因素分析

DOI: 10.7507/1002-0179.20150293, PP. 1019-1022

Keywords: 蜂螫伤,过敏反应,流行病学,危险因素,预后

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Abstract:

目的?了解四川部分地区蜂螫伤相关过敏反应的发生情况、危险因素、诊治现状及其对预后的影响。方法?回顾性分析四川省内不同地区9家医院2010年1月1日-2011年12月31日到急诊科就诊的387例蜂螫伤患者资料,采集资料包括患者一般信息、就诊时病情、就诊后接受治疗情况及至离院后1个月内的随访资料。采用非条件logistic逐步回归法分析蜂螫伤后过敏反应发生的危险因素;采用Fisher确切概率法分析发生过敏反应对患者死亡的影响。结果?387例蜂螫伤患者中,41例(10.6%)出现过敏反应,过敏患者的年龄高于未过敏组,差异有统计学意义(P<0.05)。非条件logistic回归分析显示年龄为患者蜂螫伤后发生过敏反应的独立危险因素OR=0.983,95%CI(0.967,0.999),P=0.042。41例发生过敏反应的患者就诊后均全身使用糖皮质激素,其中16例患者联用抗组胺类药物,无患者使用肾上腺素。16例发生全身性过敏反应的患者中,12例患者24h内静脉补液量<1000mL。发生过敏反应的患者病死率(9.8%)高于未过敏者(1.4%),差异有统计学意义(P=0.009)。结论?蜂螫伤过敏患者的病死率显著高于非过敏患者。年龄是蜂螫伤后发生过敏反应的独立危险因素。对蜂螫伤相关严重过敏反应的救治尚有待进一步规范。

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