不同蛇毒血清对竹叶青蛇咬伤后凝血功能的影响

Effect of Different Antivenom Serum on Coagulation Function after the Bite of the Trimeresurus Stejnegeri

目的:比较不同抗蛇毒血清对竹叶青蛇咬伤后凝血功能的影响。方法:选取龙岩市第二医院2017年9月至2020年11月期间收治的50例竹叶青蛇咬伤患者,随机分为A组与B组,各25例。A组给予抗五步蛇毒血清,B组给予抗蝮蛇毒血清。观察两组患者凝血功能指标变化情况,分析诊疗过程及诊疗效果。结果:A组患者凝血功能平均恢复时间为(3.68±1.41)d,短于B组患者的(5.56±2.26)d,差异具有统计学意义(P<0.05)。A组患者治疗后第2、4天,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及凝血酶时间(TT)均短于B组,纤维蛋白酶原(Fib)水平高于B组,差异具有统计学意义(P<0.05)。结论:在治疗竹叶青蛇咬伤患者时采用抗五步蛇毒血清具有较好的效果,与抗蝮蛇毒血清相比,能更好地改善患者的凝血功能异常情况,缩短治疗时间,促进患者尽早康复。

Objective To observe the effects of different antivenoms on the coagulation function of trimeresurus stejnegeri bite.Methods A total of 50 patients with snakebite of trimeresurus stejnegeri treated in the Second Hospital of Longyan from September 2017 to November 2020 were selected and randomly divided into group A and group B,with 25 cases in each group.Group A was given agkistrodon acutus antivenin,group B was given agkistrodon hyalys antivenin.The changes of coagulation function indexes in the two groups were observed,and the diagnosis and treatment process and effects were analyzed.Results The average recovery time of coagulation function in group A was(3.68±1.41)d,shorter than that in group B(5.56±2.26)d,and the difference was statistically significant(P<0.05).On the 2nd and 4th day after treatment,PT,APTT and TT levels in group A were lower than those in group B,while Fib was higher than that in group B,with statistical significance(P<0.05).Conclusion In the treatment of trimeresurus stejnegeri bite patients,agkistrodon acutus antivenin has a better effect,compared with agkistrodon halys antivenin,can better improve the coagulation function of patients with abnormal conditions,shorten the treatment time,promote patients to recover as soon as possible.