1139例毒蛇咬伤患者临床资料分析

Clinical Materials Analysis on 1139 Cases of Venomous Snake Bite Patients

目的了解某地区毒蛇咬伤流行病学特点以及患者就诊时间对病情和疗效的影响。方法利用HIS系统回顾性调查2012年~2015年某院收治的毒蛇咬伤患者1139例,对其性别、年龄、职业、咬伤地点和咬伤季节以及咬伤-就诊时间、病情分型、并发症、住院天数和疗效进行资料分析。结果某地区毒蛇咬伤男女构成比为2:1,40岁~69岁年龄段患者达60.32%,农民占患者的68.48%,夏秋季是蛇伤的高发季节。就诊时间<3小时患者占就医人数的59.61%,占病情轻症的97.20%,占并发急性肾衰和伤口坏死均为0.15%。就诊时间<3小时患者住院1天~2天的比例明显地高于其它就诊时间(P<0.05)。并且随着咬伤-就诊时间延长,病情严重程度增加、并发症发生率和住院天数增多的趋势。治疗转归是痊愈91.57%,好转5.62%,总有效率为97.19%。结论野外和田间劳作者夏秋季慎防毒蛇咬伤,咬伤后要在3小时内住院就医,可以避免病情加重、减少并发症和缩短住院时间、保证治疗效果。

Objectives To investigate the influence of epidemiology characteristics and prehospital time of venomous snake bite patients to the illness state and treatment effect.Methods To conduct retrospectively investigation on 1139 cases of venomous snake bite patients admitted in our hospital from 2012 to 2015 with the application of HIS system.The sex,age,occupation,bite place,bite season,prehospital time,disease classification,complication,hospitalization days and treatment effect of these patients were analyzed according to the data.Results The gender constituent ratio of the region was 2：1,the patients aged from 40 to 69 years accounted for 60.32%,and peasant patients accounted for 68.48%.The summer and autumn were high morbidity seasons for snake bite.The patients whose prehospital time were within 3 hour occupied 59.61%of all cases and occupied97.20%of mild cases.The group whose prehospital time were within 3 hours had a shorter length of hospitalization than other groups（P〈0.05）.And with the extension of prehospital time,the illness and complication would be more serious and got a longer length of hospitalization.The treatment effect of recovery occupied for 91.57%and the improvement occupied for 5.62%,the total efficient rate was 97.19%.Conclusions The workers in filed or farm should prevent from venomous snake bite in summer and autumn.To come for treatment within 3 hours could avoid condition aggravation,reduce complication,shorten the length of hospitalization,and get a better treatment effect.