早期伤口切开对蝮蛇咬伤患者预后的影响

Effect of early wound incision on prognosis of agkistrodite bite

目的:探讨早期伤口切开对蝮蛇咬伤患者预后的影响。方法:回顾性分析安徽中医院大学第一附属医院急诊科2015-03-2016-09诊治的60例蝮蛇咬伤患者,根据患者致伤后6h内就诊我院时伤口切开与否,分为不切开组(31例)、切开组(29例),并对2组的临床指标包括局部肿胀评分、住院天数、炎症指标、心肌酶进行统计学分析。结果:2组治疗前肿胀程度比较无明显差异。2组治疗后第4天肿胀程度较治疗前减轻(P<0.05或P<0.01),并且切开组肿胀程度大于不切开组;不切开组住院天数少于切开组(P<0.05);2组炎症指标及心肌酶各指标在治疗前无明显差异。2组治疗后WBC、CRP、CK、CK-MB、肌红蛋白较治疗前明显下降(P<0.05或P<0.01),且不切开组治疗后WBC、CRP、CK、CK-MB、肌红蛋白水平优于切开组(P<0.05)。结论:蝮蛇咬伤后不宜行伤口切开。

Objective：To investigate the effect of early wound incision on the prognosis of susceptible agkistrodite bites.Method：Retrospective analysis of the First Affiliated Hospital of Anhui University Hospital emergency department From March 2015 to September 2016 diagnosis and treatment of 60 cases of Viper bites,according to the patient within 6hafter the treatment of our hospital wound incision or not,points（n=31）and incision group（n=29）.The clinical indexes of the two groups included local swelling score,length of hospital stay,inflammation index and myocardial enzyme were analyzed statistically.Result：There was no significant difference in the degree of swelling before treatment.The swelling degree of the two groups was significantly lower than that of the untreated group（P〈0.05 or P〈0.01）,and the degree of swelling was less than that of the incision group（P〈0.05）.There were no significant differences between the two groups.WBC,CRP,CK,CK-MB and myoglobin were significantly decreased after treatment（P〈0.05 or P〈0.01）,and WBC,CRP,CK,CK-MB and myoglobin were better than those of the incision group（P〈0.05）.Conclusion：The wound of agkistrodite bites should not be cut open.