蜂蛰伤后不同时间血常规、心肌酶谱及肝肾功的变化

目的通过对蜂蛰伤患者血常规、心肌酶谱及肝肾功的检测和分析,评价其对预后的影响,为临床治疗蜂蛰伤提供策略和依据。方法选取我院2013年4～9月收治的蜂蛰伤患者48例,分别于入院后8 h、3 d和7 d、临床治愈出院前,检测其血常规、心肌酶谱及肝肾功等指标。结果蜂蛰伤患者血常规及肝功、心肌酶谱多在8 h内出现异常（P〈0.05）,1 w左右开始恢复。肾功损害多晚于血常规及心肌酶谱异常,且于3～7 d达高峰（P〈0.05）。出院前血白细胞总数、心肌酶谱均正常,但肾功、血红蛋白仍异常（P〈0.05）。结论蜂蛰伤后血白细胞数升高、心肌和肝脏损害出现较早,但恢复也最快,而肾功损害出现晚且恢复慢。提示血常规、心肌酶谱、肝功可作为蜂蛰伤早期预后的判断指标,肾功损害是患者后期预后的重要影响因素。

Changes of blood,myocardial zymogram and hepatic and renal functions at different time after bee sting

Objective To evaluate the impacts of bee sting on prognosis by means of examination and analysis of the changes in the blood,myocardial zymogram and hepatic and renal functions of the patients at different time after bee sting,and to provide strategies and basis for clinical treatment of bee sting.Methods Total 48 bee-sting patients receiving treatment in our hospital from Apr.of 2013 to Sep.of the same year were selected.Their blood,myocardial zymogram and hepatic and renal functions were examined after 8 h,3 d,and 7 d since the treatment and before they left our hospital.Results The routine blood indexes,myocardial zymogram and hepatic and renal functions of the patients within 8 h after bee sting were abnormal（P〈0.05）,but they began to recover about one week later.Mostly,renal damage occurred latter than the abnormality of routine blood indexes and myocardial zymogram,and reached the peak in 3-7 d（P〈0.05）.Before they left the hospital,the counts of white blood cells and myocardial zymogram were normal,but the renal function and hemoglobin still were different from the normal values（P〈0.05）.Conclusion After bee sting,the counts of white blood cells of the patients increase and myocardial and hepatic damage occur early,but recover the fastest;while renal damage occurs later and recovers the slowest.It is indicated that routine blood indexes,myocardial zymogram and hepatic function can be used as judgment indexes for early prognosis of bee sting,and renal damage is an important affecting factor for prognosis of patients in the later stage.