毒蛇咬伤患者早期使用抗菌药物的对比研究

Comparative study of early application of antimicrobial to patients with snakebite

目的探讨毒蛇咬伤患者早期是否需要预防性使用抗菌药物。方法选取2009年4月1日-2014年11月30日该院收治的毒蛇咬伤住院患者154例,分为预防性使用抗菌药物组(A组)和未使用抗菌药物组(B组),比较两组患者脓肿、溃疡、发热、脓毒症、截肢及死亡的发生率和平均住院时间。结果 A组脓肿、溃疡、发热、脓毒症、截肢及死亡的发生率分别为2.53%、21.51%、12.66%、7.59%、0.00%和0.00%;B组分别为2.67%、21.33%、12.00%、6.67%、0.00%和0.00%,两组发生率比较差异均无统计学意义(P>0.05)。A组平均住院时间[(5.84±1.43)d]与B组[(5.91±1.64)d]比较,差异无统计学意义。结论蛇咬伤患者在没有明确感染时不需要使用抗菌药物。

[Objective] To study whether the snakebite patients need preventive use of antimicrobial or not. [Methods] Totally 154 patients admitted to our hospital from April 1, 2009 to November 30, 2014 for blood circulation poisoning of snakebite were randomly divided into groups A and B. Antimicrobial was used in group A but not used in group B. The incidences of abscess, ulcer, fever and sepsis were observed and compared. The incidences of amputation and death, and the average hospitalization days were also compared. [Results] In the group B the rates of the abscess, ulcers, fever and sepsis were 2.67%, 21.33%, 12.00%, 6.67%, respectively. In the group A, they were 2.53%, 21.51%, 12.66%, 7.59%. There were no statistically significant differences between both groups （P 〉 0.05）. The incidences of amputation and death were zero. The average hospital stay was （5.84 ± 1.43） days in the group A and （5.91 ± 1.64） days in group B without significant difference. [Conclusion] Snakebite patients without definite infection do not need use of antimicrobial.