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对入住儿科急诊诊所的蝎子蜇伤患者的回顾性评估。

Retrospective Evaluation of Patients With Scorpion Stings Admitted to the Pediatric Emergency Clinic.

作者信息

Tunç Feyat, Yıldız Süleyman, Devecioglu Mehmet Celal, Yolbas İlyas, Aktar Fesih

机构信息

Pediatrics and Child Health, Batman Training and Research Hospital, Batman, TUR.

Pediatrics and Child Health, Mardin Derik State Hospital, Mardin, TUR.

出版信息

Cureus. 2022 Sep 26;14(9):e29606. doi: 10.7759/cureus.29606. eCollection 2022 Sep.

Abstract

Introduction Scorpion sting in children is still a serious health problem today. Children are at greater risk of developing severe cardiac, respiratory, and neurological complications because of their low body weight. In this study, we retrospectively evaluated the demographical changes, complaints, clinical findings, and laboratory results of scorpion sting cases admitted to the pediatric emergency department.  Materials and Methods The records of 72 patients who were followed up with the diagnosis of scorpion sting in the Dicle University Pediatric Emergency Department between 2013 and 2017 were retrospectively analyzed. Results The patients included in the study were between one and 15 years (7.64±4.04 years) and 43.1% were male, and 56.9% were female. While 65.3% of the cases lived in rural areas, 34.7% lived in the city center. The most common stung areas in the cases were the lower extremity (51.4%) and the upper extremity (34.7%). The most common complaints in the patients were 70.8% pain, 58.3% edema, 41.7% cold extremities, 23.6% sweating, 22.2% vomiting, and 12.5% excessive salivation. Of the cases, 71.4% had mild, 25.7% had moderate, and 2.9% had severe stages. Of the patients, 91.6% were given antivenom, 75.7% were given antihistamines, 74.3% were given steroids, 65.7% were given antibiotics, 64.3% were given analgesics, 44.3% were given tetanus vaccine, 2.8% were given erythrocyte suspension and 1.4% were given platelet suspension. In addition, 11.4% of the cases were given prazosin treatment. While 32.9% of the cases required intensive care, two patients died. A statistically significant difference was found between the glucose, urea, creatine, total protein, sodium, potassium, alanine aminotransferase, white blood cell count, red blood cell count, hemoglobin, hematocrit, neutrophil count values of the patients at admission and discharge. Conclusion Scorpion sting cases are still a significant health problem. The severe clinical course is more common in children. The management of patients with severe clinical forms is based on early recognition of the sting, antivenom serum administration, and cardiorespiratory and systemic support.

摘要

引言 如今,儿童蝎子蜇伤仍是一个严重的健康问题。由于儿童体重较低,他们发生严重心脏、呼吸和神经并发症的风险更高。在本研究中,我们回顾性评估了儿科急诊科收治的蝎子蜇伤病例的人口统计学变化、主诉、临床发现和实验室结果。

材料与方法 回顾性分析了2013年至2017年在狄克莱大学儿科急诊科确诊为蝎子蜇伤并接受随访的72例患者的记录。

结果 纳入研究的患者年龄在1至15岁之间(平均7.64±4.04岁),男性占43.1%,女性占56.9%。65.3%的病例居住在农村地区,34.7%居住在市中心。病例中最常被蜇伤的部位是下肢(51.4%)和上肢(34.7%)。患者最常见的主诉为疼痛(70.8%)、水肿(58.3%)、四肢发冷(41.7%)、出汗(23.6%)、呕吐(22.2%)和流涎过多(12.5%)。71.4%的病例处于轻度阶段,25.7%处于中度阶段,2.9%处于重度阶段。91.6%的患者接受了抗蛇毒血清治疗,75.7%接受了抗组胺药治疗,74.3%接受了类固醇治疗,65.7%接受了抗生素治疗,64.3%接受了镇痛药治疗,44.3%接受了破伤风疫苗接种,2.8%接受了红细胞悬液输注,1.4%接受了血小板悬液输注。此外,11.4%的病例接受了哌唑嗪治疗。32.9%的病例需要重症监护,2例患者死亡。患者入院和出院时的血糖、尿素、肌酐、总蛋白、钠、钾、丙氨酸转氨酶、白细胞计数、红细胞计数、血红蛋白、血细胞比容、中性粒细胞计数之间存在统计学显著差异。

结论 蝎子蜇伤病例仍然是一个重大的健康问题。严重的临床病程在儿童中更为常见。对临床症状严重的患者的治疗基于对蜇伤的早期识别、抗蛇毒血清的应用以及心肺和全身支持。

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