非出血倾向蛇咬伤患者的局部治疗

The topical therapy for snake bite patients without coagulation disorders

目的:探讨非出血倾向蛇咬伤患者的局部治疗。方法:将符合入选条件的120例患者随机分为切开组(A组)与保守组(B组),两组患者全身治疗方法相同。切开组患者给予局部皮肤切开排毒,以33%硫酸镁溶液湿敷患肢,保守组患者局部给予饱和盐水浸泡及33%硫酸镁溶液湿敷患肢,交替进行。比较两组患者脏器损伤、血肌红蛋白(Mb)水平、骨筋膜室综合征及感染发生情况、疼痛程度、住院时间的差异。结果:两组患者器官功能障碍、骨筋膜室综合征发生情况、血Mb水平无显著差异(P>0.05)。切开组患者疼痛程度及感染发生率显著高于保守组患者(P<0.05),且住院时间显著长于保守组(P<0.05)。结论:对于脏器损伤水平为轻型且无出血倾向的蛇咬伤无需将伤口切开引流,局部治疗可采用患肢的高渗液体浸泡与湿敷。

Objective: T o assess the clinical efficacy of treatment for local tissue in the management of snake bite without coagulationdisorders. Methods: 120 patients with snake bite were randomized into two groups. All patients received the same systemic therapy.Group A was incised and wet compressed with magnesium sulfate solutions. Group B was steeped into saturated salt solution and wetcompressed with magnesium sulfate solutions. The organ injury,the level of serum M b,acute limb compartment syndrome and infectionrate,pain intensity and duration of hospitalization were compared between the two groups. Results:There is no statistically significantdifference in the organ injury, the level of serum Mb, acute limb compartment syndrome rate between the two groups (P > 0. 05 ) . Theinfection rate, pain intensity are more significant in group A ( P < 0. 05) and there is longer duration of hospitalization in group A( P < 0 .0 5 ) . Conclusion:It is not necessary for snake bite patients with light organ damage to be incised.