江西省分宜县112例毒蛇咬伤患者凝血功能检测结果分析

Analysis of coagulation function in 112 patients bitten by poisonous snakes in Fenyi County of Jiangxi Province

目的:探讨毒蛇咬伤患者凝血功能变化情况。方法:选择江西省分宜县人民医院外科2018年3月—2023年7月收治的112例毒蛇咬伤患者作为研究对象,其中蝮蛇56例,竹叶青28例,银环蛇16例,眼镜蛇12例。对不同毒蛇种类患者的各时段行凝血功能检测,并对检测结果进行比较分析。结果:对不同蛇类治疗前、治疗后1 d、治疗后3 d的三个时期的指标进行F方差分析,发现只有竹叶青蛇组治疗前后差异有统计学意义(P<0.05),蝮蛇、银环蛇、眼镜蛇组差异无统计学意义(P>0.05)。竹叶青蛇组治疗前、治疗后1 d、治疗后3 d三个时期指标进行两两比较,进行t检验,结果表明竹叶青蛇咬伤患者治疗前凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(DDi)、纤维蛋白原(Fbg)存在异常,治疗后指标得到显著改善,差异有统计学意义(P<0.05)。结论:竹叶青蛇咬伤患者可引起较严重的凝血功能异常。

Objective:To Investigate the changes of coagulation function in patients bitten by venomous snake.Methods:A total of 112 cases of snakebite patients admitted to the People's Hospital of Fenyi County in Jiangxi Province from March 2018 to July 2023 were selected as the study subjects,including 56 cases of Russell's viper,28 cases of bamboo pit viper,16 cases of Chinese green tree viper,and 12 of cobra.The results of coagulation function test in different kinds of patients were compared and analyzed.Results:The three period indexes of different snakes were analyzed by F variance respectively,it was found that only the bamboo leaf green snake group had statistical significance before and after treatment(P<0.05),and the coagulation function indexes of pit viper,silver snake and cobra groups had no statistical significance(P>0.05).Then the t test was carried out by pairwise comparison of the three stages of the group.The results showed that the prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),D-dimer(DDi)and fibrinogen(Fbg)of the patients with bamboo snake bite were abnormal before treatment,and the indexes were significantly improved after treatment,with statistical significance(P<0.05).Conclusion:Patients bitten by bamboo green snake can cause serious coagulation dysfunction.