广西壮族自治区1市4县毒蛇种类分布特征研究及快速准确诊断毒蛇咬伤的策略分析  

Study on distribution characteristics of venomous snake species in four counties of one city in Guangxi Zhuang Autonomous Region rapid accurate diagnostic strategies of poisonous snakebite

作　　者：罗毅[1,2] 张剑锋 李其斌[4] 翟崇宇[1,2] 余培南 刘芹 Luo Yi;Zhang Jianfeng;Li Qibin;Zhai Chongyu;Yu Peinan;Liu Qin(Liuzhou People's Hospital,Liuzhou 545006,Guangxi Zhuang Autonomous Region,China;Liuzhou Traditional Chinese Medicine Hospital/Snake Injury Treatment Base in Central and Northern Guangxi Zhuang Autonomous Region,Liuzhou 545001,Guangxi Zhuang Autonomous Region,China;the Second Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;Wuzhou Traditional Chinese Medicine Hospital,Wuzhou 543002,Guangxi Zhuang Autonomous Region,China;College of Life Science and Food Engineering,Yibin University,Yibin 644000,Sichuan,China)

机构地区：[1]柳州市人民医院急诊科,广西壮族自治区柳州545006 [2]柳州市中医医院急诊科,桂中桂北蛇伤救治基地,广西壮族自治区柳州545001 [3]广西医科大学第二附属医院急诊科,广西壮族自治区南宁530021 [4]广西医科大学第一附属医院急诊科,广西壮族自治区南宁530021 [5]梧州市中医院中医外科,广西壮族自治区梧州543002 [6]宜宾学院生命科学与食品工程学院,四川宜宾644000

出　　处：《中国中西医结合急救杂志》2020年第3期338-343,共6页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广西壮族自治区柳州市科研与技术开发计划项目(2017BH20302);广西壮族自治区柳州市人民医院院内科研基金(lry201901)。

摘　　要：目的 从蛇伤临床诊断视角结合现有动物学资料,开展广西壮族自治区1市4县毒蛇种类分布特征研究,探讨该研究指导快速准确诊断毒蛇咬伤的意义.方法 依据地级市、县级政府提供的资料确认研究区域经纬度、海拔,查阅权威动物学专著确认每种蛇的经纬度、垂直、省份分布,从理论上框定研究区域分布的蛇种.以蛇伤科学研究为由向研究区域行政部门申请办理捕蛇证,依据理论框定的蛇种科学设计蛇种类调查图谱及问卷调查表,从蛇伤临床标本(Ⅰa级证据)、野生蛇种科研标本(Ⅰb级证据)、问卷调查(Ⅱ级证据)、临床图片(Ⅲ级证据)4个维度,采用分级证据法探讨以县、地市为单位的毒蛇种类分布特征.结果 从理论上确认框定研究区域有毒蛇6科4亚科40属92种蛇类,其中毒蛇25种,无毒蛇67种;前钩牙剧毒蛇7种,管状毒牙剧毒蛇8种,口腔上腭部有Duvernoy腺体的剧毒蛇种2种,后沟牙低毒蛇8种.共获得I级证据共90件,毒蛇Ⅰ级证据50件,证实毒蛇分布种类14种;其中毒蛇Ⅰa级临床标本证据15件,分为3科3亚科8属9种蛇类;毒蛇Ib级科研标本证据35件,分为3科3亚科10属11种蛇类;调查范围覆盖1市4县、31镇、13乡、207村.收集问卷调查Ⅱ级证据共1001份,证实毒蛇分布种类20种;其中桂中桂北蛇伤救治基地在长期临床实践中收集Ⅲ级临床图片证据233张,证实毒蛇分布种类11种.整合Ⅰ、Ⅱ、Ⅲ级证据,证实广西壮族自治区1市4县毒蛇种类分布特征.结论 广西壮族自治区1市4县毒蛇种类丰富,其分布具备显著区域特性;以县、地市为单位的毒蛇种类分布特征研究为制作区域性蛇伤诊断图鉴用于蛇伤快速准确诊断奠定理论基础.Objective To carry out a study of distribution characteristics of venomous snake species in four counties of one city in Guangxi Zhuang Autonomous Region from the perspective of clinical diagnosis of snakebite combined with the existing zoological data,and discuss the significance of this study in guiding rapid accurate diagnosis of poisonous snakebite.Methods According to the data provided by prefecture level city and county government,the longitude,latitude and altitude of the study area were confirmed,by consulting the authoritative zoology monograph,the longitude,latitude,vertical and provincial distribution of each snake species were determined,and theoretically the distribution of snake species in the study area was framed.To carry out scientific research of snakebite,a certificate was obtained for catching snakes from various related regional administration department of the government.Based on the theoretical framework of snake species,the investigation atlas and questionnaires of snake species were scientifically designed,and from the four dimensions of snake injury clinical specimen(Ⅰa level evidence),wild snake species scientific research specimen(Ⅰb level evidence),questionnaire investigation(Ⅱlevel evidence)and clinical picture(Ⅲlevel evidence),hierarchical evidence method was used to approach the distribution characteristics of viper species in an unit,such as county,prefecture and city.Results Theoretically,there were 92 snake species in 6 families,4 subfamilies and 40 genera in the study area,including 25 species of poisonous snakes and 67 species of non poisonous snakes;in the 25 species poisonous snakes,there were Proteroglyphic teeth intensive poisonous snake 7 species,Solenoglyphic teeth high poisonous snake 8 species,high poisonous snake with Duvernoy's glands at the upper palate of the mouth 2 species and Opisthoglyphic teeth low poisonous snake 8 species.Totally 90 class I evidences and 50 classⅠevidences of vipers were obtained,demonstrating there were 14 species of vipers distri

关 键 词：毒蛇分布 区域性蛇伤诊断图鉴 蛇咬伤快速准确诊断 

分 类 号：Q95[生物学—动物学]