[1]牟天易,曹小平,阳雪梅,等.不同治疗方案对蛇咬伤后患肢肿胀的临床疗效比较[J].医学信息,2019,32(05):119-120123.[doi:10.3969/j.issn.1006-1959.2019.05.037]
　MOU Tian-yi,CAO Xiao-ping,YANG Xue-mei,et al.Comparison of Clinical Effects of Different Treatment Regimens on Swollen Limbs after Snake Bites[J].Medical Information,2019,32(05):119-120123.[doi:10.3969/j.issn.1006-1959.2019.05.037]
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不同治疗方案对蛇咬伤后患肢肿胀的临床疗效比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年05期
页码:
119-120123
栏目:
临床研究
出版日期:
2019-03-01

文章信息/Info

Title:
Comparison of Clinical Effects of Different Treatment Regimens on Swollen Limbs after Snake Bites
文章编号:
1006-1959（2019）05-0119-03
作者:
牟天易1; 曹小平1; 阳雪梅2; 李志恒1; 尹松林1
（1.川北医学院附属医院急诊科，四川 南充 637000；2.南充市营山县人民医院，四川 南充 637700）
Author(s):
MOU Tian-yi1; CAO Xiao-ping1; YANG Xue-mei2; LI Zhi-heng1; YIN Song-lin1
(1.Department of Emergency,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China;2.Yingshan County People’s Hospital,Nanchong 637700,Sichuan,China)
关键词:
咬伤; 肢体肿胀; 疼痛程度评分
Keywords:
Snake bite; Limb swelling; Pain score
分类号:
R453.9
DOI:
10.3969/j.issn.1006-1959.2019.05.037
文献标志码:
A
摘要:
目的 观察不同治疗方案对蛇咬伤后患肢肿胀的疗效，为临床提供最佳的治疗方案。方法 选取我科收治的毒蛇咬伤后患肢肿胀的患者120例，将其随机分为A组（常规治疗组），B组（常规治疗+活动患肢），C组（常规治疗+活动患肢+患肢行小切口），D组（常规治疗+活动患肢+患肢行大切口），每组30例。比较4组患者患肢疼痛程度、肿胀消退时间、住院时间、住院费用情况。结果 ①A、B、C、D 4组患肢疼痛程度评分分别为（3.26±0.44）分、（4.58±0.48）分、（6.44±0.32）分、（8.15±0.28）分；A组患肢疼痛最轻，D组最重。②4组患肢肿胀消退时间分别为（11.32±1.22）d、（7.42±0.92）d、（5.00±0.74）d、（3.44±0.52）d；D组肿胀消退最快，A组肿胀消退最慢。③4组住院时间分别为（11.46±1.07）d、（7.48±0.85）d、（14.32±1.69）d、（21.69±2.65）d，住院费用分别为（0.88±0.10）万元、（0.60±0.07）万元、（1.41±0.16）万元、（3.25±0.37）万元，B组住院时间最短且住院费用最低。结论 常规治疗联合活动患肢，对蛇咬伤后非骨筋膜室综合征的患肢肿胀治疗可能是最佳治疗方案。
Abstract:
Objective To observe the effect of different treatment regimens on the swelling of the affected limb after snake bite, and to provide the best treatment for the clinic. Methods A total of 120 patients with swollen limbs after the snake bite in our department were randomly divided into group A (conventional treatment group), group B (conventional treatment + active limb), group C (conventional treatment + active disease) Limb + limbs with small incision), group D (conventional treatment + active limb + large limb incision), 30 cases in each group. The degree of pain in the limbs, the time to resolve the swelling, the length of hospital stay, and the cost of hospitalization were compared between the four groups. Results ①The scores of pain in the A, B, C, and D groups were (3.26±0.44), (4.58±0.48), (6.44±0.32), and (8.15±0.28), respectively.Group A suffered the least pain in the affected limb and the D group was the heaviest. ②The swelling time of the affected limbs in the 4 groups was (11.32±1.22) d, (7.42±0.92) d, (5.00±0.74) d, (3.44±0.52) d; the swelling in group D was the fastest, and the swelling in group A was the slowest.③The hospitalization time of 4 groups was (11.46±1.07)d, (7.48±0.85)d, (14.32±1.69)d, (21.69±2.65)d, the hospitalization expenses were (0.88±0.10) ten thousand dollars, (0.60±0.07) ten thousand dollars, (1.41±0.16) ten thousand dollars, and (3.25±0.37) ten thousand dollars. Group B had the shortest hospital stay and the lowest hospitalization expenses. Conclusion Conventional treatment combined with active limbs may be the best treatment for the treatment of limb swelling in non-elastic compartment syndrome after snake bite.

参考文献/References:


[1]姜胜文,吴家和,周宗艳.中小学生毒蛇咬伤的流行病学特征[J].广西医学,2018,40(19):2363-2365.
[2]刘刚,和七一,王文文,等.蛇毒神经毒素和肌肉毒素研究进展[J],动物科学,2015,32(4):38-41.
[3]严广斌.视觉模拟评分法[J].中华关节外科杂志,2014,8(2):273.
[4]刘治昆,蒋笑怡,李清平.中西医结合治疗五步蛇咬伤患肢肿胀44例体会[J].蛇志,2012,24(2):147-148.
[5]王琥,朱晋鸣,曹晖.140例蝮蛇咬伤时间与心肌酶谱及肢体肿胀关系分析[J].中国医学创新,2014,11(13):1-4.
[6]王缓缓.血清TNF-α、IL-1、IL-6及hs-CRP水平与竹叶青蛇伤患者肢体肿胀及病情严重程度的相关性研究[D].福建中医药大学,2015.
[7]李其斌,吕传柱,梁子敬,等.2018年中国蛇伤救治专家共识[J].中华急诊医学杂志,2018,27(12):1315-1322.
[8]Elbey B,Baykal B,Yazgan ?C,et al.The prognostic value of the neutrophil/lymphocyte ratio in patients with snake bites for clinical outcomes and complications[J].Saudi J Biol Sci,2017,24(2):362-366.
[9]毕方刚,陈聚伍.封闭负压引流在治疗蛇咬伤中应用[J].中华实用诊断与治疗杂志,2012,26(3):281-282．
[10]朱大年,王庭槐.生理学[M].北京:人民卫生出版社,2013:125-127.
[11]曹小平,曹钰.急诊医学[M].北京:科学出版社,2014:363-368.

更新日期/Last Update: 2019-03-01