目前国内外尚缺乏蜂螫伤规范化诊治相关的指南，临床工作中存在对蜂螫伤可能导致的严重损伤早期病情评估不足及缺乏统一的治疗方案等问题，从而影响预后。为此，四川省急诊医学专委会特组织了中毒与复苏学组专家在对四川省内蜂螫伤发病情况及诊疗现状进行初步流行病学调查的基础上，对蜂螫伤诊治进展进行了总结，形成了《四川省蜂螫伤规范化诊治专家共识》，作为蜂螫伤治疗的指导。然而蜂螫伤治疗的疗效受多种因素影响，只有结合具体情况，在规范化基础上进行个体化治疗才能达到最佳治疗效果。随着相关临床证据的不断积累，专家委员会也将对共识内容进行不断更新。
ObjectiveTo identify the clinical features of and risk factors for allergic reaction to bee stings in Sichuan. MethodWe retrospectively analyzed the clinical data of 387 patients with bee stings admitted to the Emergency Department of nine hospitals in Sichuan during January 1, 2010 to December 31, 2011, and evaluated the risk factors for bee sting anaphylaxis with logistic regression analysis, and explored the influence of anaphylaxis on death with Fisher exact probability method. ResultsAmong the 387 patients with bee stings, 41 (10.6%) had allergic reactions. The age in patients from the anaphylaxis group was significantly older than those in the non-anaphylaxis group (P<0.05). Logistic regression analysis showed that age was an independent risk factor for allergic reaction in patients with bee stings[OR=0.983, 95%CI (0.967, 0.999), P=0.042]. All the patients with allergic reactions were prescribed with systemic corticosteroids, and 16 were prescribed with antihistamine drugs, but no patients were prescribed with epinephrine. Among the 16 patients with systemic allergic reaction, 12 were given less than 1000 mL intravenous rehydration per 24 h, 2 were given 1000-3000 mL intravenous rehydration, and only 2 were given more than 3 000 mL intravenous rehydration. The mortality of allergic patients was significantly higher than that of the non-allergic group (9.8% vs 1.4%, P<0.05). ConclusionsThe mortality of anaphylaxis patients is significantly higher than that of the non-anaphylaxis group. Age is an independent risk factor for allergic reactions to bee stings. Treatment of bee stings related to severe allergic reaction needs to be further standardized.