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目的:探讨抗蝮蛇毒血清应用方式对重症蝮蛇咬伤预后的影响。方法:将47例重症蝮蛇咬伤患者随机分为治疗组、对照组,2组患者均接受常规治疗,治疗组加用抗蝮蛇毒血清局部封闭。比较2组患者的器官功能损害程度、治愈率、平均住院时间。结果:2组患者入院0天器官功能损害程度比较无统计学差异(P>0.05)。而入院3天后治疗组、对照组Hgb、STB、Scr分别为91.3±15.6、21.8±9.5、266±62,86.4±16.4、23.7±8.9、274±73,无统计学差异(P>0.05);ALT、CK-MB、LDH分别为195±102、546±653、2343±2289,448±331、995±896、5124±4969,有显著的统计学差异(P<0.01)。治疗组、对照组患者的平均住院日分别为13.55±7.86、19.24±10.38,有统计学差异(P<0.05),治愈率比较无统计学差异(P>0.05)。结论:联合抗蝮蛇毒血清局部封闭,能明显减轻重症蝮蛇咬伤患者的器官功能损害程度,缩短患者的平均住院时间,值得临床推荐。
Objective: To investigate the effect of anti-snake venom serum application on the prognosis of severe snakebite. Methods: 47 cases of severe viper snake bites patients were randomly divided into treatment group, control group, two groups of patients were treated routinely, the treatment group plus anti-snake venom serum local closed. The degree of organ dysfunction, the cure rate and the average length of hospital stay were compared between the two groups. Results: There was no significant difference in organ dysfunction between the two groups on day 0 of admission (P> 0.05). After 3 days of admission, the Hgb, STB and Scr of the treatment group and the control group were 91.3 ± 15.6, 21.8 ± 9.5, 266 ± 62, 86.4 ± 16.4 and 23.7 ± 8.9, 274 ± 73 respectively, with no significant difference (P> 0.05). ALT, CK-MB and LDH were 195 ± 102,546 ± 653,2343 ± 2289,448 ± 331,995 ± 896,5124 ± 4969 respectively, with significant difference (P <0.01). The average hospitalization days of the treatment group and the control group were 13.55 ± 7.86 and 19.24 ± 10.38 respectively, with statistical difference (P <0.05). There was no significant difference in the cure rate between the two groups (P> 0.05). Conclusion: The local sedation of the combined anti-snake venom serum can significantly reduce the degree of organ dysfunction in patients with severe snakebite and shorten the average length of hospital stay, which is worthy of clinical recommendation.