抗蝮蛇毒血清静脉输液速度对蝮蛇咬伤患者凝血功能影响的研究  

Influence of the Infusion Speed of Agkistrodon Halys Antivenin on the Coagulation Function of the Victim Suffering from the Snake-bite

作　　者：王颂扬[1] 邹利群[1] 

机构地区：[1]四川大学华西医院急诊科,成都610041

出　　处：《华西医学》2014年第6期1037-1039,共3页West China Medical Journal

摘　　要：目的探讨抗蝮蛇毒血清的使用以及其输注时间对患者凝血功能的影响。方法回顾性收集2013年4月1日-11月30日首诊于急诊科的蝮蛇咬伤患者的临床资料,根据其过敏试验结果将所有患者分为皮试阴性组和皮试阳性组。再根据两组患者输注抗蝮蛇毒血清时间的长短,将阴性组患者分为输液时间≤1.5 h组和>1.5 h组;阳性组患者分为输液时间≤3 h组和>3 h组;记录所有患者的性别、年龄、输注时间、以及输注抗蝮蛇毒血清前后患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)纤维蛋白原(FIB)、D-二聚体(D-Dimer)等指标的情况。比较输注抗蝮蛇毒血清前后以及不同输注时间对患者的凝血功能相关指标的影响。结果阴性组和阳性组输注抗蝮蛇毒血清治疗后,患者的PT、APTT、TT、FIB、D-Dimer均较输注前有所改善,差异均具有统计学意义,输液时间≤1.5 h组和≤3 h组分别较输液时间>1.5 h组和>3 h组患者的上述凝血功能相关纠正更明显,差异有统计学意义(P<0.05)。结论抗蝮蛇毒血清能够纠正蛇咬伤患者凝血功能,且输注速度越快对凝血功能的改善效果更明显。Objective To explore the use ofagkistrodon halys antivenin, and the influence of its infusion time on the coagulation function of the patient bitten by agkistrodon halys. Methods We retrospectively analyzed the clinical data of patients suffering from pit viper bites and first diagnosed and treated in the emergency department of our hospital between April 1 and November 30, 2013. According to the allergy test results, patients were divided into two groups： negative and positive. Based on the infusion time, the negative patients were divided into ≤ 1.5 hours and 〉 1.5 hours groups, and the positive patients were divided into ≤ 3 hours and 〉 3 hours groups. All patients＇ gender, age, infusion time, and PT, APTT, TT, FIB, D-DIMER before and after infusion of antivenomous serum were recorded, and blood coagulation indicators before and after infusion of antivenomous serum and the impact of infusion time were compared among different groups. Results For both the negative and positive groups, PT, APTT, TT, FIB, and D-DIMER were statistically improved after infusion of antivenomous serum. The blood coagulation indicators of infusion time ≤ 1.5 hours group and ≤3 hours group were significantly better than those of infusion time 〉 1.5 hours and 〉 3 hours groups. Conclusion Antivenomous serum can correct coagulation and the faster infusion rate, the more obvious the effect is.

关 键 词：抗蝮蛇毒血清 输液速度 凝血功能 

分 类 号：R646[医药卫生—外科学]