87例竹叶青蛇咬伤急诊救治临床研究

Clinical study on emergency treatment of 87 cases of trimeresurus stejnegeri bites

目的探讨竹叶青蛇咬伤患者急诊救治时间对住院时间、多器官功能衰竭发生率、病死率、后遗症发生率的影响。方法回顾性分析我院急救中心2012年12月~2018年6月收治的87例竹叶青蛇咬伤中毒患者的临床资料,按照被竹叶青蛇咬伤至就诊时间分为三组:咬伤后≤2h就诊组(A组),2~6h就诊组(B组),≥6h就诊组(C组);统计三组患者住院时间、多器官功能衰竭发生率、病死率、后遗症发生率等项目。结果竹叶青蛇咬伤中毒者中,三组都未出现病死的情况,C组患者平均住院时间、多器官功能衰竭发生率和后遗症发生率均呈现明显高于A、B两组的结果,并且B组患者在住院时间和后遗症发生率比A组明显偏多,在多器官功能衰竭发生率与A组差异无统计学意义。C组患者平均治疗费用远高于A组和B组,差异有统计学意义,B组患者平均治疗费用也高于A组,差异有统计学意义。结论患者被竹叶青蛇咬伤后急诊救治的时间越短,经过正确地救治后,其住院时间、多器官功能衰竭发生率、病死率、后遗症发生率就越小,为降低后遗症,器官衰竭的发生,减少住院时间,蛇咬伤后需及时就诊、察症诊断、施治。

Objective To explore the effect of emergency treatment time on the hospital stay, the incidence of multiple organ failure,the mortality rate and the incidence of sequelae in patients with trimeresurus stejnegeri bites.Methods Clinical datas of 87 patients with trimeresurus stejnegeri bites poisoning who were admitted and treated in our emergency center in our hospital from December 2012 to June 2018 were retrospectively analyzed.According to the time from the time of being bitten by the trimeresurus stejnegeri to the time of seeking medical treatment,they were divided into three groups:the seeking medical treatment after bite for less than or equal to 2 h group(group A),the seeking medical treatment after bite for 2 h to 6 h group(group B) and the seeking medical treatment after bite for more than or equal to 6 h group(group C).The hospital stay,the incidence of multiple organ failure,the mortality rate,and the incidence of sequelae in the three groups were counted. Results In patients with trimeresurus stejnegeri bites poisoning,there was no case of death in all three groups.The average length of hospital stay,the incidence of multiple organ failure and the incidence of sequelae in group C were significantly higher than those in group A and group B.The length of hospital stay and incidence of sequelae in group B were significantly higher than those in group A and the incidence of multiple organ failure was not significantly different from that in group A.The average cost of treatment in group C was much higher than that in group A and group B,and the difference was statistically significant.The average cost of treatment in group B was also higher than that in group A,and the difference was statistically significant.Conclusion The shorter the time for emergency treatment after the patient is bitten by the trimeresurus stejnegeri is,the shorter the hospital stay and the less the incidence of multiple organ failure,the mortality rate and the sequelae after correct treatment are.In order to reduce the sequelae,the occurrence of organ failure and hospital stay.It is necessary to timely see a doctor,observe symptoms to diagnosis and treat after snake bites.