Ekrem Koyuncu, Onur Balcı, Arda Kılıç, Veysi Almaz, Cemil Kaya, Kenan Yılmaz, Ali Yıldırım

Çocuk Acil Servisine Akrep Sokması Nedeniyle Başvuran Olgularının Değerlendirilmesi

Giriş: Akrep sokmaları özellikle tropikal ve tropik altı iklim kuşaklarında yaygın olmak üzere birçok az gelişmiş ülkede önemli bir sağlık problemidir. Materyal ve Metod: Çalışmamızda Ocak 2010- Ocak 2015 yılları arasında çocuk acil polikliniğine akrep sokması şikayeti nedeniyle başvuran 424 akrep sokması olgusunun dosya kayıtları ve hasta tabelaları geriye dönük olarak incelendi. Bulgular: Başvuran hastaların yaş ortalaması 82,1±19,5 ay olup, 228'i (%53,4) kız, 196'sı (%46,6) erkek idi. Hastaların ağırlıklarının medyan değeri 19,3±4,2 iken, boy dağılımlarının medyan değeri 104±8,2 cm idi. Hastalar tutulum evresine göre gruplandırıldığında 306'sı (%72,1) evre 1,83'ü (%19,6) evre 2,35'i (%8,3) evre 3 olduğu görüldü. Olguların 72'si (%16,98) ilkbahar, 254'ü (%59,90) yaz, 96'sı (%22,64) sonbahar mevsiminde hastanemize başvurdu. Olguların ısırılma yeri dağılımlarına bakıldığında 339 (%79,95) olgu ekstremiteden, 58 (%13,67) olgu gövdeden, 27 (%6,36) olgunun baş ve boyun bölgesinden ısırıldığı görüldü. En sık tespit edilen bulgular ısırık yerindeki lokal bulgular olup, olguların 368'inde (%86,79) ısırık yerinde kızarıklık ve eritem mevcuttu. Kardiyovasküler sistem bulgulardan en sık taşikardi mevcut olup 274 (%64,62) olguda görülmekteydi. Olguların 12'sinde sistolik disfonksiyon geliştiği tespit edildi. Hastaların çoğu taburcu edilirken 4 hasta kardiyojenik şok ve multiorgan yetersizliği nedeniyle exitus oldu. Sonuç: Akrep sokması vakaları özellikle Güneydoğu Anadolu bölgesi başta olmak üzere ülkemizde halen önemli bir sağlık problemidir. Özellikle yaz aylarında görülme sıklığı artmaktadır. Solunum, kardiyovasküler, nörolojik ve gastrointestinal sistem tutulumu görülür ve nadiren ölüm ile sonlanabilmektedir

Anahtar Kelimeler:

Çocuk, Isırık, Akrep

Evaluation of Scorpion Sting Cases Admitted to Department of Pediatric Emergency

Introduction: Scorpion stings represent an important health problem in many developing countries, particularly in the tropic and subtropic areas of the world. Materials and Methods: Aretrospective examination of patient files and treatment charts was performed for a total of 424 cases presenting with scorpion stings to the pediatric emergency department between January 2010 and January 2015. Results: The mean age of the patients was 82.1 ± 19.5 months. There were 228 (%53,4) female and 196 (%46,6) male patients, with a median body weight of 19.3 ± 4.2 kg, and median height of 104 ± 8.2 cm. Three-hundred and six patients (72.1%) had stage 1, 83 (19.6%) had stage 2 and 35 (8.3%) had stage 3 disease. Of the scorpion stings 72 (16.98%), 254 (59.90%), and 96 (22.64%) occurred in spring, summer, or autumn, respectively. The distribution of the site of sting involved the extremities in 339 (79.95%), trunk in 96 (22.64%) and head and neck in 27 (6.36%). The most common signs involved those locally occurring at the site of the sting, with erythema and redness found in 368 cases (86.79%). Of the cardiovascular signs, tachycardia occurred in 274 cases (64.62%) and 12 had systolic dysfunction. While the great majority of the cases could be discharged uneventfully, 4 patients died due to cardiogenic shock and multiorgan failure. Conclusions: Scorpion stings remain a major health problem in our country, particularly in the South East Anatolia. The incidence of scorpion stings is highest during the summer season. The most common forms of involvement include respiratory, cardiovascular, neurological and gastrointestinal involvement, with rare occurrence of mortality

Keywords:

Children, Sting, Scorpion,

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