抗蛇毒血清危机干预研究

Snake antivenins crisis intervention therapy

目的探讨毒蛇咬伤抗蛇毒血清危机干预疗法的临床疗效。方法2010年8月-2011年12月为前瞻性观察期，台州市中心医院急诊科实施血清危机干预治疗76例（干预组）；2007年11月-2010年8月为历史对照期，实施蛇伤程序化救治139例（血清组），比较两组间的蛇伤种类、临床分型、住院天数、致残率、死亡率、好转率等。计数资料以率表示，采用x^2检验，计量资料以G-±s）表示，采用t检验，以P〈0．05为差异具有统计学意义。结果干预组人院后治疗费用、并发症率明显高于血清组，差异均有统计学意义（P〈0．05），两组人院后疗效评价如致残率、死亡率、好转率比较，差异均无统计学意义（P〉0．05）。结论实施血清危机干预方案，缓解血清难求的局面，为健全急救药储备体系提供依据。

Objective To explore the clinical effect of snake antivenins crisis intervention therapy to snakebite. Methods An analysis was performed： a comparison was made between a collection of 76 cases of antivenins crisis intervention therapy which was used as the intervention group for prospective observation period in between August 2008 and December 201 l and the other collection of 139 cases of procedural serum therapy which served for historical control period between November 2007 and August 2008. The comparison made included snake bite species, clinical classification, length of hospital stay, disability and mortality, and reeovery, and etc. The data was analyzed by adopting chi-square test, and expressed by the measurement of mean＋_SD and t-test, with P〈 0.05 （statistical difference）. Results The average length of stay, the cost and the complication for antivenins crisis intervention group were significantly higher than in the serum group with statistical significance （P 〈 0.05）. Expression on disability, mortality, as well as recovery obtained from the two respective groups demonstrated with no statistical significance （P〉O.05）. Conclusion Implementation of antivenins crisis intervention therapy was aimed to ease the situation of antivenins shortage, and provide as reference for emergency medicine system.