Visitsunthorn Nualanong, Kijmassuwan Teera, Visitsunthorn Kittipos, Pacharn Panchama, Jirapongsananuruk Orathai
From the Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Pediatr Emerg Care. 2019 Sep;35(9):600-604. doi: 10.1097/PEC.0000000000001200.
The purpose of this study was to evaluate the clinical characteristics of allergy to stings from the Hymenoptera order of insects in a hospital in Thailand.
A descriptive retrospective analytical study was carried out in inpatients and outpatients suffering from Hymenoptera stings from 2009 to 2013 in Siriraj Hospital.
Medical records of 386 patients with an allergy to Hymenoptera stings were evaluated. Anaphylaxis was more common in patients younger than 15 years, who comprised 22.3% of patients in this study. The most common sting type was from wasps (58.3%). Eighty-five percent of patients sought medical treatment less than 24 hours after being stung. A systemic reaction and anaphylaxis were found in 9.9% and 4.4% of subjects, respectively. In 17 patients with anaphylaxis, only 11 patients (64.7%) received an epinephrine (adrenaline) injection as treatment, and only 8 (47.1%) received epinephrine autoinjectors or epinephrine-prefilled syringes to prevent a possible subsequent severe reaction. Significantly more patients younger than 15 years received epinephrine for prevention of an allergic reaction than did those older than 15 years (87.5% vs 11.7%, P < 0.001). Antibiotics were given to 43.0% of patients.
Anaphylaxis from Hymenoptera stings was more common in children than in adults. Only half of the patients visited the emergency room within 1 hour of being stung. Overuse of antibiotics and underuse of epinephrine were found. More information about Hymenoptera stings should be provided to the public, and the use of epinephrine should be encouraged in the case of severe reactions and anaphylaxis.
本研究旨在评估泰国一家医院中膜翅目昆虫蜇伤过敏的临床特征。
对2009年至2013年在诗里拉吉医院就诊的膜翅目昆虫蜇伤的住院和门诊患者进行描述性回顾性分析研究。
对386例膜翅目昆虫蜇伤过敏患者的病历进行了评估。过敏反应在15岁以下患者中更为常见，占本研究患者的22.3%。最常见的蜇伤类型是黄蜂（58.3%）。85%的患者在被蜇伤后不到24小时就寻求了医疗救治。分别有9.9%和4.4%的受试者出现全身反应和过敏反应。在17例过敏反应患者中，只有11例（64.7%）接受了肾上腺素注射治疗，只有8例（47.1%）接受了肾上腺素自动注射器或预充式肾上腺素注射器以预防可能随后发生的严重反应。15岁以下接受肾上腺素预防过敏反应的患者明显多于15岁以上患者（87.5%对11.7%，P<0.001）。43.0%的患者使用了抗生素。
膜翅目昆虫蜇伤引起的过敏反应在儿童中比成人更常见。只有一半的患者在被蜇伤后1小时内前往急诊室。发现存在抗生素过度使用和肾上腺素使用不足的情况。应向公众提供更多关于膜翅目昆虫蜇伤的信息，并鼓励在发生严重反应和过敏反应时使用肾上腺素。
