早期应用抗蛇毒血清中和游离毒素对南方毒蛇伤的应用效果(1)
【摘要】 目的：探讨早期应用抗蛇毒血清中和游离毒素对南方毒蛇伤的应用效果。方法：纳入2018年5月-2019年5月笔者所在医院收治的80例毒蛇伤疾病患者，按照随机分组的方式分为两组，接受常规救治的设为对照组，接受早期应用抗蛇毒血清治疗的设为研究组，对比两组临床效果。结果：治疗前两组BUN、TB、TT、PT对比差异无统计学意义(P>0.05)，治疗后两组BUN、TB、TT、PT均低于治疗前，且研究组各指标均低于对照组，差异均有统计学意义(P<0.05);研究组治疗总有效率高于对照组，差异有统计学意义(P<0.05)。结论：南方毒蛇伤患者积极采取急救救治措施，同时早期应用抗蛇毒血清中和游离毒素，可促进毒素排出，防止肝肾功能损伤，值得在临床上进行推广。
【关键词】 早期应用抗蛇毒血清 游离毒素 南方毒蛇伤 治疗效果
doi：10.14033/j.cnki.cfmr.2020.24.006 文献标识码 A 文章编号 1674-6805(2020)24-00-03
[Abstract] Objective： To investigate the effect of early application of antivenin and free toxin on venomous snake injury in southern China. Method： A total of 80 patients with viper injury admitted to the author’s hospital from May 2018 to May 2019 were included. The patients were randomly divided into two groups， those who received routine treatment were set as the control group， and those who received early treatment with antivenom were set as the study group. The clinical effects of the two groups were compared. Result： Before treatment， there was no significant difference in BUN， TB， TT and PT between the two groups (P>0.05)， after treatment， BUN， TB， TT and PT in the two groups were all lower than those before treatment， and all indexes in the study group were lower than those in the control group， the differences were statistically significant (P<0.05). The total effective rate of the treatment group was higher than that of the control group， the difference was statistically significant (P<0.05). Conclusion： The patients with venomous snake injury in southern China should actively take emergency treatment measures， and at the same time early use of antivenoms to neutralize free toxins， promote toxin excretion， and prevent liver and kidney function damage. The results of this study confirmed that it is worth promoting in clinical practice.
[Key words] Early application of antivenin serum Free toxin Southern poisonous snake wound Treatment effect
First-author’s address： Shenzhen University Pinghu Hospital， Shenzhen 518111， China
我國南方气候宜人，有利于蛇类动物的繁衍生息，根据相关数据报道，全世界毒蛇种类约有650种，而我国境内发现的毒蛇种类约有50种，大多数分布在我国的云南、福建、广西、广东等地区，且多数南方人认为蛇属于滋补良品，故而捕蛇、捉蛇、杀蛇、吃蛇的人数较多，导致医院接收的蛇毒伤患者人数久居不下[1]。毒蛇咬伤属于急危重症，患者的临床表现为四肢发软、呼吸衰弱、全身无力等，随着蛇毒在全身的蔓延，患者会出现多个器官衰竭，最终导致死亡，故而在患者被毒蛇咬伤后，应立即为其采取救治措施，以挽救患者的生命[2]。本次研究中，探究毒蛇咬伤患者在早期运用抗蛇毒血清治疗的临床效果，现将研究结果报道如下。
1 资料与方法
1.1 一般资料
纳入2018年5月-2019年5月笔者所在医院收治的毒蛇伤疾病患者80例，纳入标准：均为南方蛇毒咬伤;患者既往无严重心脏疾病、肝肾衰竭;在救治过程中，未接受过抗蛇毒血清治疗。排除标准：妊娠及哺乳期女性;恶性肿瘤;患者拒绝参与本次研究。按照随机分组的方式分为对照组及研究组，对照组40例，女18例(45.0%)，男22例(55.0%)，年龄8～83岁，平均(43.81±3.91)岁;其中银环蛇咬伤12例，五步蛇咬伤4例，眼镜蛇咬伤13例，蝰蛇咬伤8例，其他蛇咬伤3例。研究组40例，女23例(57.5%)，男17例(42.5%)，年龄8～83岁，平均(43.81±3.91)岁;其中银环蛇咬伤13例，五步蛇咬伤3例，眼镜蛇咬伤12例，蝰蛇咬伤7例，其他蛇咬伤5例。两组基线期资料比较差异无统计学意义(P>0.05)。本次研究所有资料均至医学伦理会报备，获得伦理批件后开展。, 百拇医药(谭杜勋 谭新宇 李娜)
【关键词】 早期应用抗蛇毒血清 游离毒素 南方毒蛇伤 治疗效果
doi：10.14033/j.cnki.cfmr.2020.24.006 文献标识码 A 文章编号 1674-6805(2020)24-00-03
[Abstract] Objective： To investigate the effect of early application of antivenin and free toxin on venomous snake injury in southern China. Method： A total of 80 patients with viper injury admitted to the author’s hospital from May 2018 to May 2019 were included. The patients were randomly divided into two groups， those who received routine treatment were set as the control group， and those who received early treatment with antivenom were set as the study group. The clinical effects of the two groups were compared. Result： Before treatment， there was no significant difference in BUN， TB， TT and PT between the two groups (P>0.05)， after treatment， BUN， TB， TT and PT in the two groups were all lower than those before treatment， and all indexes in the study group were lower than those in the control group， the differences were statistically significant (P<0.05). The total effective rate of the treatment group was higher than that of the control group， the difference was statistically significant (P<0.05). Conclusion： The patients with venomous snake injury in southern China should actively take emergency treatment measures， and at the same time early use of antivenoms to neutralize free toxins， promote toxin excretion， and prevent liver and kidney function damage. The results of this study confirmed that it is worth promoting in clinical practice.
[Key words] Early application of antivenin serum Free toxin Southern poisonous snake wound Treatment effect
First-author’s address： Shenzhen University Pinghu Hospital， Shenzhen 518111， China
我國南方气候宜人，有利于蛇类动物的繁衍生息，根据相关数据报道，全世界毒蛇种类约有650种，而我国境内发现的毒蛇种类约有50种，大多数分布在我国的云南、福建、广西、广东等地区，且多数南方人认为蛇属于滋补良品，故而捕蛇、捉蛇、杀蛇、吃蛇的人数较多，导致医院接收的蛇毒伤患者人数久居不下[1]。毒蛇咬伤属于急危重症，患者的临床表现为四肢发软、呼吸衰弱、全身无力等，随着蛇毒在全身的蔓延，患者会出现多个器官衰竭，最终导致死亡，故而在患者被毒蛇咬伤后，应立即为其采取救治措施，以挽救患者的生命[2]。本次研究中，探究毒蛇咬伤患者在早期运用抗蛇毒血清治疗的临床效果，现将研究结果报道如下。
1 资料与方法
1.1 一般资料
纳入2018年5月-2019年5月笔者所在医院收治的毒蛇伤疾病患者80例，纳入标准：均为南方蛇毒咬伤;患者既往无严重心脏疾病、肝肾衰竭;在救治过程中，未接受过抗蛇毒血清治疗。排除标准：妊娠及哺乳期女性;恶性肿瘤;患者拒绝参与本次研究。按照随机分组的方式分为对照组及研究组，对照组40例，女18例(45.0%)，男22例(55.0%)，年龄8～83岁，平均(43.81±3.91)岁;其中银环蛇咬伤12例，五步蛇咬伤4例，眼镜蛇咬伤13例，蝰蛇咬伤8例，其他蛇咬伤3例。研究组40例，女23例(57.5%)，男17例(42.5%)，年龄8～83岁，平均(43.81±3.91)岁;其中银环蛇咬伤13例，五步蛇咬伤3例，眼镜蛇咬伤12例，蝰蛇咬伤7例，其他蛇咬伤5例。两组基线期资料比较差异无统计学意义(P>0.05)。本次研究所有资料均至医学伦理会报备，获得伦理批件后开展。, 百拇医药(谭杜勋 谭新宇 李娜)