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目的:研究北方地区蝮蛇咬伤中毒早期对凝血系统的影响。方法:对我科2009-6-2011-06接诊的38例北方地区蝮蛇咬伤后24h之内患者的血小板计数(PLT)及凝血系统指标D-二聚体(D-Dimer)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原(Fg)及凝血酶时间(TT)作一回顾性分析,并与健康对照组共20例进行相应指标的比较。结果:蝮蛇咬伤组中,5例患者出现PLT减少,与对照组的差异无统计学意义,PT延长8例,TT延长11例,D-D升高21例,与对照组有统计学差异。而APTT和Fg均正常,与对照组的差异无统计学意义。结论:北方地区蝮蛇咬伤中毒早期在一定程度上影响患者凝血功能,但大多数患者不影响PLT计数;有纤溶增强表现,但较少造成严重脱纤维蛋白血症,较少引起DIC或DIC样综合征,需要继续观察及复查。
Objective: To study the effects of viper snake bite poisoning on the coagulation system in the north of China. Methods: The platelet count (PLT), coagulation index D-dimer (D-Dimer) and blood plasma in 38 cases of northern snakebite in northern China from 2009-6-2011-06 were retrospectively analyzed. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg) and thrombin time (TT) were retrospectively analyzed and compared with the healthy control group, a total of 20 patients with corresponding indicators Compare Results: In the viper snakebite group, PLT decreased in 5 patients, but there was no significant difference with the control group. PT was prolonged in 8 cases, TT prolonged in 11 cases and D-D increased in 21 cases, which was significantly different from the control group. The APTT and Fg were normal, and the control group, the difference was not statistically significant. CONCLUSIONS: Northern snakebite poisoning affects the coagulation function to a certain extent in the early stage, but most patients do not affect the PLT count; fibrinolytic performance is enhanced but seizures less severe and fibrosis less likely to cause DIC or DIC-like syndrome, need to continue to observe and review.