儿童蝎子蜇伤评估

M. Parlak, Erdoğan Öz, Osman Küçükkelepçe
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摘要

在世界许多地方,蝎子蜇伤都是一个严重的公共卫生问题。儿童被蝎子螫伤后出现严重并发症的风险较高,包括心脏、呼吸和神经系统并发症。在土耳其,布氏蝎科蝎子是造成严重中毒事件的最常见元凶。这项回顾性描述研究在土耳其进行。研究纳入了 2017 年 12 月至 2020 年 12 月期间在 Kahta 州立医院急诊科住院的 0 至 18 岁儿童。研究回顾了患者信息,并纳入了 78 名具有完整人口统计学、实验室和临床数据的患者。在78名患者中,24.4%的患者年龄在6岁或6岁以下,75.6%的患者年龄在6岁以上。12.8%的患者使用了α受体阻滞剂,43.6%的患者使用了抗蛇毒血清。在 78 名患者中,71.8% 在急诊科接受了随访,21.8% 在住院部接受了随访,6.4% 在重症监护室接受了随访。两名患者(2.6%)在一个月内死亡。蛰伤部位不同,乳酸脱氢酶值也有明显差异(P=0.014)。头颈部和上肢被蛰患者的乳酸脱氢酶值高于下肢被蛰患者。白细胞、天门冬氨酸转氨酶和乳酸脱氢酶等特定实验室参数的升高与较差的预后有关。此外,头部、颈部和上肢被蛰伤与病情严重程度的关系更为密切。这些发现为针对蝎子蜇伤的治疗策略提供了指导,并有可能通过对不同地区和人群进行更广泛的研究而进一步完善。
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Evaluation of Scorpion Stings in Children
Scorpion stings are a significant public health problem in many parts of the world. Children are at a higher risk of developing severe complications from scorpion envenoming, including cardiac, respiratory, and neurologic complications. In Turkey, members of the Buthidae family are the most common culprits in severe envenoming events. This retrospective-descriptive study was conducted in Turkey. Children aged 0 to 18 y admitted to the emergency department of Kahta State Hospital between December 2017 and December 2020 were included in the study. Patient information was reviewed, and 78 patients with complete demographic, laboratory, and clinical data were included in the study. Out of the 78 patients, 24.4% were six years old or younger while the 75.6% were older than six years. Alpha blocker was given to 12.8% of the patients, and antivenom was given to 43.6% of the patients. Of the 78 patients, 71.8% were followed up in the emergency department, 21.8% were followed up in the inpatient unit, and 6.4% were followed up in the intensive care unit. Two patients (2.6%) died within 1 month. There was a significant difference regarding lactate dehydrogenase value according to the sting site ( P=0.014). Lactate dehydrogenase values of patients stung on the head and neck and upper extremity were higher than those of patients bitten on lower extremities. Elevated levels of specific laboratory parameters, such as leukocytes, aspartate transaminase, and lactate dehydrogenase, are linked to worse outcomes. Additionally, stings on the head, neck, and upper extremities are more strongly associated with severity. These findings guide tailored treatment strategies for scorpion stings, with the potential for further refinement through broader studies across diverse regions and populations.
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