摘要
目的讨论低分子肝素钠治疗重型和危重型竹叶青蛇咬伤中毒早期的临床效果。方法简单随机选取2020年6月—2021年12月于厦门市第五医院收治的70例重型和危重型蛇咬伤中毒早期患者为研究对象,将其随机分为对照组与研究组,各35例。两组患者均接受常规对症处理,对照组采取抗蛇毒血清及血液灌流治疗,研究组在对照组基础上接受低分子肝素钠治疗。观察两组患者的中毒症状消失时间、并发症、凝血指标、肝肾功能指标。结果研究组M样症状、N样症状、CNS样症状消失时间均显著短于对照组,差异有统计学意义(t=6.458、5.771、14.392,P<0.05)。研究组并发症发生率为5.71%,明显低于对照组的28.57%,差异有统计学意义(χ^(2)=6.436,P<0.05)。干预后研究组凝血酶时间[(13.13±1.58)s]、活化部分凝血活酶时间[(26.99±3.22)s]、凝血酶原时间[(9.43±0.54)s]均明显低于对照组,差异有统计学意义(t=7.087、3.541、8.757,P<0.05)。干预后研究组门冬氨酸氨基转移[(28.66±3.53)U/L]、丙氨酸氨基转移酶[(35.64±4.18)U/L]、肌酐[(73.30±5.37)μmol/L]、尿素氮[(4.20±0.86)μmol/L]均明显低于对照组,差异有统计学意义(t=4.369、5.044、3.873、5.118,P<0.05)。结论治疗重型和危重型竹叶青蛇咬伤中毒早期病症时采纳低分子肝素钠治疗手段,有利于改善患者凝血状态以及肝肾功能、加快中毒症状消失、减少并发症。
Objective To discuss the early clinical effect of low molecular weight heparin sodium in the treatment of severe and critically severe snake bite poisoning by green snake.Methods 70 patients with severe and critical snake bite poisoning treated at the Xiamen Fifth Hospital from June 2020 to December 2021 were simple randomly selected as the research object and randomly divided into control group and study group,with 35 cases each.Both groups of patients received routine symptomatic treatment,the control group received antivenom and hemoperfusion therapy,and the study group received low molecular weight heparin sodium therapy on the basis of the control group.The time to disappearance of poisoning symptoms,complications,coagulation indexes,liver and kidney function indexes between the two groups were observed.Results The disappearance time of M-like symptoms,N-like symptoms,and CNS-like symptoms in the study group was significantly shorter than that in the control group,the difference was statistically significant(t=6.458,5.771,14.392,P<0.05).The incidence of complications in the study group was 5.71%,which was significantly lower than that in the control group(28.57%),the difference was statistically significant(χ^(2)=6.436,P<0.05).After intervention,the thrombin time[(13.13±1.58)s],activated partial thromboplastin time[(26.99±3.22)s]and prothrombin time[(9.43±0.54)s]in the study group were significantly lower than those in the control group,the difference was statistically significant(t=7.087,3.541,8.757,P<0.05).After intervention,aspartate aminotransferase[(28.66±3.53)U/]L,alanine aminotransferase[(35.64±4.18)U/L],creatinine[(73.30±5.37)μmol/L],urea nitrogen[(4.20±0.86)μmol/L]in the study group were significantly lower than those in the control group,the difference was statistically significant(t=4.369,5.044,3.873,5.118,P<0.05).Conclusion Low molecular weight heparin sodium is used in the treatment of early symptoms of severe and critical snakebite poisoning of green snake,which is beneficial to improve the coagulation state and liver and kidney function of patients,accelerate the disappearance of poisoning symptoms,and reduce adverse complications.
作者
罗春鸣
李百来
阙茂棋
LUO Chunming;LI Bailai;QUE Maoqi(Emergency Department,Xiamen Fifth Hospital,Xiamen,Fujian Province,361101 China)
出处
《中外医疗》
2022年第28期141-145,共5页
China & Foreign Medical Treatment
关键词
竹叶青蛇
咬伤
低分子肝素钠
中毒
Green snake
Bite
Low molecular weight heparin sodium
Poisoning
