竹叶青蛇咬伤患者凝血功能指标的变化及临床意义

Clinical Significance of Clotting Index Changes in Patients Bitten by Green Bamboo Snake

目的观察竹叶青蛇咬伤患者凝血功能指标的变化及临床意义。方法取2013年6月-2016年8月医院收治的竹叶青蛇咬伤患者50例,设为观察组,入院后患者立即采用抗蛇毒血清注射,辅以民间蛇伤膏和中药治疗。取同期入院健康体检者50例,设为对照组。入院后检测两组凝血功能指标,包括：血小板（PLT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）及纤维蛋白原定量（Fg）水平,分析竹叶青蛇咬伤患者凝血功能指标变化情况。结果治疗前观察组凝血功能指标中PT、APTT及TT水平高于对照组（P〈0.05）,PLT和Fg指标水平低于对照组（P〈0.05）;观察组治疗后凝血功能指标PT、APTT及TT水平低于治疗前（P〈0.05）,PLT和Fg指标水平高于治疗前（P〈0.05）。结论竹叶青蛇咬伤患者凝血功能指标发生明显的变化,临床采用抗蛇毒血清和中草药治疗后凝血功能得到改善,治疗过程应加强凝血功能水平监测,指导临床治疗。

Objective This article aim to observe the clotting index changes in patients bitten by green bamboo snake and its clinical significance. Methods The experiment took 50 patients who was admitted to hospital from June 2013 to August 2016 due to snake bite by green bamboo snake as experimental group. Meanwhile,it took 50 healthy patients who was admitted to hospital at the same time as control group. Patients from experimental group was got antivenoms injection,traditional Chinese medicine and traditional anti-snake cream right after their admission. Detailed blood examination including：the platelet（PLT）,prothrombin time（PT）,activated partial clotting enzyme live time（APTT）,thrombin time（TT）and fibrinogen quantitative level（Fg）was applied to all these two groups to analyze the blood coagulation index changing in green bamboo snake bitten patients. Results The blood coagulation result showed patient＇s PT,APTT and TT index in experimental group were higher than that in control group before treatment（P〈0.05）. The PLT and Fg index of experimental group patients were lower than that in control group before treatment（P〈0.05）. Comparing to the index before treatment,experimental group patient＇s PT,APTT and TT were getting lower and the PLT and Fg were getting higher（P〈0.05）,after treatments. Conclusion Clinical treatment of antivenoms injection and traditional Chinese medicine significant improved green bamboo snake bitten patient＇s blood coagulation function. In the later cases,strengthen observation of the blood coagulation function index should be taken into consideration to guide further clinical treatment.