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目的 总结提高毒蛇咬伤抢救成功率的综合救治经验。方法 1993年 1月～ 2 0 0 2年12月共收治 5 4 7例毒蛇咬伤患者 ,以应用精制抗蛇毒血清为主的综合治疗 ;治疗中注意肺、脑、肾、血液、循环功能的监护 ,早期发现、处理脏器受损 ;使用大剂量肾上腺皮质激素和山莨菪碱对抢救蛇伤患者提高临床疗效。结果 治愈 5 0 1例 (91 6 % ) ;好转 2 8例 (5 1% ) ;功能障碍 8例 (1 5 % ) ,其中植皮2例 ,截肢 2例 ,截指 (趾 ) 3例 ,肢体偏瘫 1例 ;死亡 10例 (1 8% )。结论 毒蛇咬伤致多器官衰竭是致死的高危因素 ,运用综合对症治疗可降低毒蛇咬伤的死亡率。
Objective To summarize the experience of improving the success rate of snake bite rescue. Methods From January 1993 to December 2002, 547 patients with poisonous snake bites were enrolled in this study. The patients were treated with refined anti-snake venom serum. The treatment included lung, brain, kidney, blood, circulatory function Guarding, early detection, treatment of organ damage; the use of high-dose adrenocorticotropic hormone and anisodamine on the rescue of snake-wound patients to improve clinical efficacy. RESULTS: A total of 501 cases (91.6%) were cured; 28 cases (51%) were improved; 8 cases (15%) had dysfunction, including 2 cases of skin grafting, 2 cases of amputation, 3 cases of interphalangeal 1 case of hemiplegia; 10 cases died (18%). Conclusion Multiple organ failure caused by snake bite is a risk factor for lethality. Using comprehensive symptomatic treatment can reduce the mortality rate of snake bite.