不同治疗方案对蛇咬伤后患肢肿胀的临床疗效比较

Comparison of Clinical Effects of Different Treatment Regimens on Swollen Limbs after Snake Bites

目的观察不同治疗方案对蛇咬伤后患肢肿胀的疗效,为临床提供最佳的治疗方案。方法选取我科收治的毒蛇咬伤后患肢肿胀的患者120例,将其随机分为A组(常规治疗组),B组(常规治疗+活动患肢),C组(常规治疗+活动患肢+患肢行小切口),D组(常规治疗+活动患肢+患肢行大切口),每组30例。比较4组患者患肢疼痛程度、肿胀消退时间、住院时间、住院费用情况。结果①A、B、C、D 4组患肢疼痛程度评分分别为(3.26±0.44)分、(4.58±0.48)分、(6.44±0.32)分、(8.15±0.28)分;A组患肢疼痛最轻,D组最重。②4组患肢肿胀消退时间分别为(11.32±1.22)d、(7.42±0.92)d、(5.00±0.74)d、(3.44±0.52)d;D组肿胀消退最快,A组肿胀消退最慢。③4组住院时间分别为(11.46±1.07)d、(7.48±0.85)d、(14.32±1.69)d、(21.69±2.65)d,住院费用分别为(0.88±0.10)万元、(0.60±0.07)万元、(1.41±0.16)万元、(3.25±0.37)万元,B组住院时间最短且住院费用最低。结论常规治疗联合活动患肢,对蛇咬伤后非骨筋膜室综合征的患肢肿胀治疗可能是最佳治疗方案。

Objective To observe the effect of different treatment regimens on the swelling of the affected limb after snake bite, and to provide the best treatment for the clinic. Methods A total of 120 patients with swollen limbs after the snake bite in our department were randomly divided into group A (conventional treatment group), group B (conventional treatment + active limb), group C (conventional treatment + active disease) Limb + limbs with small incision), group D (conventional treatment + active limb + large limb incision), 30 cases in each group. The degree of pain in the limbs, the time to resolve the swelling, the length of hospital stay, and the cost of hospitalization were compared between the four groups. Results ①The scores of pain in the A, B, C, and D groups were (3.26±0.44),(4.58±0.48),(6.44±0.32), and (8.15±0.28), respectively.Group A suffered the least pain in the affected limb and the D group was the heaviest.②The swelling time of the affected limbs in the 4 groups was (11.32±1.22) d,(7.42±0.92) d,(5.00±0.74) d,(3.44±0.52) d;the swelling in group D was the fastest, and the swelling in group A was the slowest.③The hospitalization time of 4 groups was (11.46±1.07)d,(7.48±0.85)d,(14.32±1.69)d,(21.69±2.65)d, the hospitalization expenses were (0.88±0.10) ten thousand dollars,(0.60±0.07) ten thousand dollars,(1.41±0.16) ten thousand dollars, and (3.25±0.37) ten thousand dollars. Group B had the shortest hospital stay and the lowest hospitalization expenses. Conclusion Conventional treatment combined with active limbs may be the best treatment for the treatment of limb swelling in non-elastic compartment syndrome after snake bite.