Chciałowski Andrzej, Abramowicz Michał, Kruszewski Jerzy
Department of Infectious Diseases and Allergology, Military Institute of Medicine, Warsaw, Poland.
Postepy Dermatol Alergol. 2019 Jun;36(3):302-307. doi: 10.5114/ada.2018.75607. Epub 2018 May 22.
Hymenoptera venom allergy (HVA) in some patients occurs with general symptoms involving respiratory and cardiovascular system with anaphylactic shock with constitutes a significant threat to life.
Assessment of the prevalence of HVA in our own material.
There were 498 patients after a general reaction to wasp and/or bee venom. The survey included questions: the type of stinging insect, body parts stung by insects, profession, frequency of stings by wasps and bees depending on professional activity, places of stings, clinical symptoms using the scale according to Muller, and the treatment following the sting. Among 498 patients, there were 281 women and 217 men.
Wasp stings were more frequent and affected 382 (77%) persons, while bee stings affected 116 (23%) persons. Limbs constituted the most common area of the body stung by both wasps and bees. The sting was more frequent in rural areas and during summer rest. A severe systemic reaction (class III and IV according to Muller) occurred more often in people stung by bees. The most common medications included intravenous glucocorticosteroids, calcium preparations and antihistamines. Intramuscular Adrenaline injection was used in 48% of patients, while only 15% received its prescription as an emergency medication. Bee stings were the most common cause of severe systemic symptoms.
The treatment after the sting in a significant percentage of episodes still deviates from the recommendations of the guidelines, especially in the field of adrenaline recommendations for patients in case of a resting by an insect.
部分患者的膜翅目昆虫毒液过敏(HVA)会出现涉及呼吸系统和心血管系统的全身症状,并伴有过敏性休克,这对生命构成重大威胁。
评估我们自身病例资料中HVA的患病率。
共有498例对黄蜂和/或蜜蜂毒液产生全身反应的患者。调查内容包括:蜇人的昆虫种类、昆虫蜇刺的身体部位、职业、根据职业活动划分的黄蜂和蜜蜂蜇刺频率、蜇刺地点、使用穆勒量表评估的临床症状以及蜇刺后的治疗情况。498例患者中,女性281例,男性217例。
黄蜂蜇刺更为常见,涉及382人(77%),而蜜蜂蜇刺涉及116人(23%)。四肢是黄蜂和蜜蜂蜇刺身体的最常见部位。农村地区和夏季休息期间蜇刺更为频繁。蜜蜂蜇刺的人发生严重全身反应(穆勒分类III级和IV级)更为常见。最常用的药物包括静脉注射糖皮质激素、钙剂和抗组胺药。48%的患者使用了肌肉注射肾上腺素,而只有15%的患者将其作为急救药物开具了处方。蜜蜂蜇刺是严重全身症状的最常见原因。
在相当一部分病例中,蜇刺后的治疗仍与指南建议不符,尤其是在昆虫蜇刺后患者肾上腺素使用建议方面。