摘要
目的分析烙铁头蛇咬伤不同时间段切开引流的临床效果。方法回顾性分析2019年3月—2019年10月重庆市急救医疗中心急诊科收治的四肢烙铁头蛇咬伤并出现肢体肿胀90例患者的临床资料、治疗前及治疗后1d血小板计数、肢体肿胀评分、蛇咬伤严重程度评分(SSS)。根据患者接受治疗的时间≤4h为A组,>4h为B组;根据治疗中是否切开引流,行切开引流患者为观察组,未行切开引流患者为对照组,对比A、B两组中观察组和对照组的治疗前及治疗后1d血小板计数、肢体肿胀评分、SSS。结果A对照组治疗前血小板计数、肢体肿胀评分、SSS分别为(173.1±97.7)×10^(9)/L、(2.1±0.4)分、(3.0±1.2)分,与A观察组[(168.7±63.0)×10^(9)/L、(2.8±0.6)分、(3.1±1.4)分]差异无统计学意义(P>0.05);A对照组治疗后1d血小板计数、肢体肿胀评分、SSS分别为(108.8±56.9)×10^(9)/L、(2.6±0.5)分、(4.1±1.4)分,与A观察组[(155.9±51.7)×10^(9)/L、(2.3±0.4)分、(2.9±1.0)分]比较差异有统计学意义(P<0.05);B对照组治疗前血小板计数、肢体肿胀评分、SSS以及治疗后1d血小板计数、蛇咬伤严重程度分别为(126.1±82.3)×10^(9)/L、(2.6±0.5)分、(4.3±1.9)分、(126.8±72.3)×10^(9)/L、(4.2±1.7)分,与B观察组(110.3±66.1)×10^(9)/L、(2.9±0.6)分、(4.9±1.7)分、(113.5±40.7)×10^(9)/L、(4.1±1.1)分比较差异无统计学意义(P>0.05);而B对照组治疗后1d肢体肿胀评分(3.1±0.5)分与B观察组(2.7±0.6)分比较差异有统计学意义(P<0.05)。结论对于烙铁头蛇咬伤伴肢体明显肿胀的患者,4h内切开引流可以减轻肢体肿胀,改善中毒程度,值得临床推广。
Objective To analyze the clinical effect of incision and drainage in different time period for treating Trimeresurus mucrosquamatus snake bite.Methods Totally 90 patients with limbs bitten by Trimeresurus mucrosquamatus and limb swelling treated in the Emergency Department of Chongqing Emergency Medical Center from Mar 2019 to Oct.2019,were enrolled in the study.The clinical data,platelet count before treatment and 1 day after treatment,limb swelling score,snake bite severity score(SSS)were collected.According to the treatment time,patients were divided into group A(treatment time≤4h)and group B(treatment time>4h);according to whether to perform incision and drainage during treatment,patients who received incision and drainage were taken as the observation group,and patients who did not receive incision and drainage were taken as the control group.The platelet count,limb swelling score,and SSS before treatment and 1 day after treatment were compared between the two groups.Results Before treatment,the platelet count,limb swelling score,and SSS of the control group A were(173.1±97.7)×10^(9)/L,(2.1±0.4)points,(3.0±1.2)points,respectively,which had no statistical difference with the observation group A[(168.7±63.1)×10^(9)/L,(2.8±0.6)points,(3.1±1.4)points,P>0.05].At 1 day after treatment,platelet count,limb swelling score,SSS of the control group A was(108.8±56.9)×10^(9)/L,(2.6±0.5)points,(4.1±1.4)points,respectively,which had statistical difference with the observation group A[(155.9±51.7)×10^(9)/L,(2.3±0.4))points,(2.9±1.0)points,P<0.05];before treatment,the platelet count,limb swelling score,SSS in the control group B were(126.1±82.3)×10^(9)/L,(2.6±0.5)points,(4.3±1.9)points,which had no statistical differences with the observation group B[(110.3±66.1)×10^(9)/L,(2.9±0.6)points,(4.9±1.7)points];at 1 day after treatment,the platelet count,SSS in the control group B were(126.8±72.3)×10^(9)/L,(4.2±1.7)points,which had no statistical difference with the observation group B[(113.5±40.7)×10^(9)/L,(4.1±1.1)points];at 1 day after treatment,the limb swelling score of control group B was(3.1±0.5)points,which had statistical difference with that of the observation group B(2.7±0.6)points,P<0.05.Conclusion For patients with obvious limb swelling caused by Trimeresurus mucrosquamatus snake bite,incision and drainage within 4 hours can reduce limb swelling and the degree of poisoning,which is worthy of clinical promotion.
作者
罗杰
熊丽
何杨俊
赵金川
杨树青
Luo Jie;Xiong Li;He Yangjun;Zhao Jinchuan;Yang Shuqing(Emergency Department,Chongqing Emergency Medical Center,Chongqing 400014,China)
出处
《创伤外科杂志》
2021年第9期701-704,共4页
Journal of Traumatic Surgery
关键词
毒蛇咬伤
肢体肿胀
切开引流
snake bites
limb swelling
incision and drainage
