心肌酶谱与凝血指标监测对蛇咬伤预后的预测价值

Predictive Value of Myocardial Enzymes and Coagulation Index Monitoring in the Prognosis of Snake Bite

目的对心肌酶谱与凝血指标平监测在蛇咬伤预后的预测中的临床价值进行分析。方法本研究分析了蛇咬伤患者78例,分析患者分布特征及心肌酶谱、凝血指标水平及变化情况。结果研究结果提示在咬伤1 d、2～3d、3～7 d三个病程时期,心肌酶谱指标水平的比较可见两组患者均因治疗干预而有所好转,但预后良好组患者心肌酶谱指标水平改善显著(P<0.05);预后良好与预后不良组随访2～3 d以及3～d天,各项指标均可见预后良好组的指标水平更优(P<0.05);不同病程时期患者凝血水平对预后的影响的分析结果与心肌酶谱指标类似。结论蛇咬伤患者初期虽然心肌损害程度以及出血倾向状态相当,但是治疗干预后指标改善缓慢,损害持续在较严重状态的患者多出现各种并发症,心肌酶谱与凝血指标平监测对临床预后具有一定的预测价值。

Objective To analyze the clinical value of myocardial enzymes and coagulation index monitoring in the prediction of the prognosis of snake bite. Methods A total of 78 patients with serpentine bites were analyzed. The distribution of myocardial enzymes and the level of coagulation and the changes were analyzed. Results The results of the study suggest that the levels of myocardial enzymes in the three days of bite for 1 day,2 -3 days,3 -7 days,the two groups of patients were improved due to treatment intervention, hut the prognosis of a good group of patients thinking （P 〈 0.05 ） , but the improvement was relatively slow;the prognosis was good and the prognosis of poor group was followed up for 2 - 3 days and 3 -7 days follow-up（P 〈 0. 05 ）. The results of the analysis of the effect of coagulation level on prognosis were similar to those of myocardial enzymes. The results showed that the prognosis of patients with different prognosis was similar to that of myocardial enzymes. Conclusion Although the degree of myocardial damage and the tendency of bleeding were similar in the early stage of snake bites, the improvement of the follow-up index was slow and the patients with more severe status had more prognosis and had a certain value in clinical prognosis .