Sigdel M R, Raut K B
Department of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
J Nepal Health Res Counc. 2013 Sep;11(25):244-50.
Wasp bite is an important occupational hazard in Nepal. Almost 25% of the victims die. This study aimed to identify the demographics, clinical presentation, hospital course and outcome of wasp bite victims in a referral hospital in Nepal.
A retrospective study was conducted in Tribhuvan University Teaching Hospital, Kathmandu. Medical records of patients admitted for wasp bite between January 2008 and December 2012 were reviewed. Demographic, clinical and laboratory data were collected and their effects on outcomes in the form of death, duration of hospitalization, number of dialysis sessions and time to resolution of oliguria were analyzed.
All 18 patients came from rural areas, 13 (72%) were farmers, mean age was 39.6 ±16.7 years (range 7 to 69). Most bites occurred between August and November. Oliguria, vomiting, red urine and jaundice were the main presenting symptoms; oliguria developed within 48 hours of bite in 17 (94 %) cases. Nine patients (50%) required blood transfusion. All developed acute renal failure (ARF) and required dialysis, mean hemodialysis session being 7.4±5.3 (range 1 to 20). Sixteen patients (89 %) received steroid for presumed interstitial nephritis. One patient expired. Mean time to resolution of oliguria was 15.9±9.5 days (range 2 to 35). Mean hospital stay was 18.7±13.4 days (range 1 to 46), those having higher number of bites had longer stay.
Wasp bite mostly affects farmers of working age in rural Nepal. Hemolysis and acute renal failure are two important complications. Timely dialysis in established acute renal failure and steroid in suspects of interstitial nephritis improves survival.
黄蜂叮咬是尼泊尔一项重要的职业危害。近25%的受害者死亡。本研究旨在确定尼泊尔一家转诊医院中黄蜂叮咬受害者的人口统计学特征、临床表现、住院过程及结局。
在加德满都的特里布万大学教学医院进行了一项回顾性研究。对2008年1月至2012年12月期间因黄蜂叮咬入院患者的病历进行了回顾。收集了人口统计学、临床和实验室数据，并分析了它们对死亡、住院时间、透析次数及少尿缓解时间等结局的影响。
所有18例患者均来自农村地区，13例（72%）为农民，平均年龄为39.6±16.7岁（范围7至69岁）。大多数叮咬发生在8月至11月。少尿、呕吐、血尿和黄疸是主要的表现症状；17例（94%）在叮咬后48小时内出现少尿。9例患者（50%）需要输血。所有患者均发生急性肾衰竭（ARF）并需要透析，平均血液透析次数为7.4±5.3次（范围1至20次）。16例患者（89%）因疑似间质性肾炎接受了类固醇治疗。1例患者死亡。少尿缓解的平均时间为15.9±9.5天（范围2至35天）。平均住院时间为18.7±13.4天（范围1至46天），叮咬次数较多者住院时间更长。
黄蜂叮咬主要影响尼泊尔农村地区的劳动年龄农民。溶血和急性肾衰竭是两个重要的并发症。在确诊急性肾衰竭时及时进行透析以及对疑似间质性肾炎患者使用类固醇可提高生存率。
