王莉萍 黄丽筠 毛明英

[摘要] 目的 探讨蜂毒中毒患者的急救和护理方法。 方法 我院于2014年1月～2015年12月收治的306例蜂毒中毒患者，入院时均被迅速准确评估病情、分流；然后给予静脉补液、抗过敏、抗休克、抗感染治疗；如果有必要可给予局部皮肤的处理；若符合血液净化指征的患者可采用血液净化治疗；同时辅以心理护理等措施，通过上述治疗达到挽救患者的生命，促使其痊愈出院的目的。 结果 300例蜂毒中毒患者康复出院，死亡6例。其中183例未行血液净化患者康复出院； 63例行单纯血液灌流治疗患者康复出院；35例患者行血液灌流联合血液透析治疗，好转出院32例，死亡3例；25例出现多器官功能障碍综合征行连续性血液净化联合血液灌流治疗，好转出院22例，死亡3例。 结论 对蜂毒中毒患者作出快速反应，给予及时有效的急救措施，密切的病情观察和护理，使患者早日康复出院。

[关键词] 蜂毒中毒；急救；护理

[中图分类号] R595 [文献标识码] B [文章编号] 1673-9701（2018）25-0158-03

[Abstract] Objective To investigate the first aid and nursing methods of bee poisoning patients. Methods The 306 cases of bee venom poisoning patients admitted to our hospital from January 2014 to December 2015 were quickly and accurately evaluated on the admission and distributary； then intravenous rehydration， anti-allergy， anti-shock， and anti-infective treatments were given； It is necessary to give local skin treatment； if blood purification is suitable for patients with blood purification indications； psychological care and other measures can be used to achieve the goal of saving the patient's life through the above-mentioned treatments and prompting them to be discharged. Results 300 cases of bee poisoning patients were discharged from the hospital and 6 died. Among them， 183 patients without blood purification were discharged from the hospital； 63 patients with simple hemoperfusion therapy were discharged from the hospital； 35 patients with hemoperfusion and hemodialysis were treated； 32 patients were discharged from hospital and 3 patients died； 25 patients had multiple organ dysfunction symptoms of continuous blood purification combined with blood perfusion treatment， 22 cases were improved and discharged， 3 cases died. Conclusion Rapid response to bee poisoning patients， timely and effective first-aid measures， close observation and care can enable patients to be discharged soon.

[Key words] Bee poisoning；First aid；Nursing

蜂類有蜜蜂、黄蜂、土蜂等，工蜂尾部有毒腺和蛰针，蛰针刺入人体后释放毒汁，其中黄蜂毒性最强，大多数研究人员认为其毒液除含有组胺外，还有5-羟色胺、胆碱酯酶、蚁酸、盐酸及神经毒碱性物质等[1，2]，毒素进入血液以后，会引起细胞损伤，增加血管的通透性，从而引起水肿、坏死等[3]，可引起被蜂蛰伤者不同的中毒反应，中毒反应因人、中毒量不同而不同，轻者可通过对症、补液、利尿等治疗后痊愈出院，而重症患者发病急、进展快，如果抢救不及时常常会危及生命。……