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泰国高养蜂区的蜂蜇伤:结局、风险及治疗模式

Bee Sting Injuries in Thailand's High Apicultural Area: Outcome, Risk and Treatment Patterns.

作者信息

Charoenwikkai Sirithanan, Intapun Premmika, Lao-Araya Mongkol

机构信息

Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.

Khanu Woralaksaburi Hospital, Saen To, Khanu Woralaksaburi, Kamphaeng Phet, 62130, Thailand.

出版信息

Risk Manag Healthc Policy. 2024 Jul 17;17:1837-1845. doi: 10.2147/RMHP.S470007. eCollection 2024.

Abstract

OBJECTIVE

This study aims to assess the clinical outcomes and risk factors associated with severe systemic reactions following bee stings, focusing on patients treated at Pa-Sang Community Hospital, located in Lamphun Province, Thailand, which is recognized as one of the country's largest apicultural areas.

METHODS

A retrospective review was conducted, utilizing electronic medical records with ICD-10 coding, of patients treated for bee sting injuries at the Emergency Department of Pa-Sang Hospital from January 2015 to December 2019.

RESULTS

This analysis included a total of 591 bee sting events involving 533 patients. The average incidence of bee sting injuries was 31.3 per 10,000 Emergency Department visits, with 55% being male. A significant majority (86%) of events occurred outside the patients' home area. Notably, the head or extremities (49%) were the most common anatomical sites stung. Systemic reactions were observed in 44% of cases, with 96 visits (16%) diagnosed as anaphylaxis. Epinephrine injection was administered in 77% of these cases, and fortunately, no fatal anaphylactic reactions were recorded. Protective factors for anaphylaxis and severe systemic reactions after bee stings included age less than 15 years old and stings on extremities. Conversely, having more than ten bee stings and seeking Emergency Department treatment within 60 minutes of being stung were identified as significant risk factors.

CONCLUSION

Bee sting injuries were a common presentation at the hospital situated in the high apicultural area, and severe systemic reactions were observed. This study highlights the need for comprehensive interventions to mitigate the increased risk of bee-related accidents in communities with thriving apicultural industries.

摘要

目的

本研究旨在评估蜂蜇伤后严重全身反应的临床结局及相关危险因素,重点关注泰国南奔府帕桑社区医院治疗的患者,该地区是泰国最大的养蜂区之一。

方法

对2015年1月至2019年12月在帕桑医院急诊科接受蜂蜇伤治疗的患者进行回顾性研究,利用带有国际疾病分类第十版(ICD - 10)编码的电子病历。

结果

该分析共纳入591例蜂蜇事件,涉及533名患者。蜂蜇伤的平均发生率为每10000次急诊科就诊31.3例,其中男性占55%。绝大多数(86%)事件发生在患者家以外的区域。值得注意的是,头部或四肢(49%)是最常被蜇的解剖部位。44%的病例观察到全身反应,其中96例(16%)被诊断为过敏反应。77%的此类病例使用了肾上腺素注射,幸运的是,未记录到致命的过敏反应。蜂蜇伤后过敏反应和严重全身反应的保护因素包括年龄小于15岁以及四肢被蜇。相反,蜂蜇次数超过十次以及蜇伤后60分钟内寻求急诊科治疗被确定为显著的危险因素。

结论

在高养蜂区的医院,蜂蜇伤是常见病症,且观察到严重全身反应。本研究强调需要采取全面干预措施,以降低养蜂业兴旺社区中与蜜蜂相关事故增加的风险。

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