98例蛇伤性溃疡防治的回顾性分析  

Retrospective analysis of the prevention and treatment of 98 cases of snake bite ulcer

作　　者：曾维兰[1] 邱红[1] 肖莉[1] 魏玲[1] 王婧 ZENG Wei-lan;QIU Hong;XIAO Li;WEI Ling;WANG Jing(Department of Emergency,Ganzhou People′s Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市人民医院急诊科,江西赣州341000

出　　处：《中国当代医药》2020年第32期69-72,共4页China Modern Medicine

摘　　要：目的对蛇伤性溃疡防治病例进行流行病学分析,总结相关防治经验为提高该类蛇伤并发症的治愈率,缩短治疗时间提供依据。方法回顾性分析2009年1~9月赣州市人民医院收治的98例蛇伤性溃疡患者的一般资料(性别、年龄、职业)和蛇伤相关疾病特征(攻击毒蛇种类,受伤部位,是否院前急救,溃疡分度及全身症状),以及入院后的治疗情况。结果患者多为以农民为职业的男性中青年(64.29%),夏季(57.14)多见;受伤部位按频次依次为足部及脚踝、小腿、手指、前臂;95.3%的患者无法确定被攻击毒蛇种类,且仅有20.0%的患者进行院前急救;50.6%的患者在伤后6 h就诊;42例Ⅰ度溃疡,48例Ⅱ度溃疡,8例Ⅲ度溃疡;平均治疗时间(10.36±1.42)d,2例肢体功能障碍。此外,就诊延迟时间越久,蛇咬伤部位溃疡分级越高,且Ⅱ~Ⅲ度溃疡发病率增高,患者不同溃疡部位治疗时间比较,差异有统计学意义(P<0.05),下肢的治疗时间长于上肢和躯干(P<0.05)。结论对蛇咬伤预防、咬伤后患者自救、就医及治疗情况回顾性分析可知,普及农村地区毒蛇咬伤患者正确院前急救,伤后及时就诊,就诊后早期对症处理,重视患肢功能锻炼是降低蛇伤溃疡发生率,减轻溃疡严重程度,促进患者康复的有效措施。Objective To improve the survival rates and reduce treatment hours of snakebite ulcer patients,the prevention and treatment experience was summarized through analysis of certain typical cases,with retrospective method.Methods A total of 98 cases of snake wound ulcer from January 2009 to September 2019 in Ganzhou People′s Hospital were concluded and analyzed.At the beginning of the study,the general information,such as sex,age,occupation and the characteristics of snake wound related diseases,such as the type of snake being attacked,the position of injury,whether to give first aid before hospital,treatment time,ulcer grades and systemic symptoms were asked and recorded in detail for the following research.Results Most of the injured patients were farmers,who are young and middle-aged men(64.29%),mostly in summer.The injured parts were feet,ankles,calves,fingers,forearms in order of frequency.95.3%of the patients did not know what types of snake they being attacked,and about 20.0%patients took measurements to help themselves.Only 50.6%of the patients went to hospital within 6 hours after attack.Through the detailed analysis,through the detailed analysis,42 cases were defined as theⅠdegree ulcer,theⅡdegree were 48 cases and of theⅢdegree were 8 cases.The average treatment time was(10.36±1.42)d,and 2 patients had limb dysfunction unfortunately.In addition,the longer the delay treatment,the higher the snakebite part ulcer classification,andⅡ-Ⅲdegree of ulcer incidence increased significantly,different part ulcer patient treatment time have differences(P<0.05),treatment time of lower extremity was obviously higher than that of upper limbs and the trunk(P<0.05).Conclusion It is an effective measure to reduce the incidence rate of snakebite ulcer and the severity of ulcer for facilitating the patients′recovery,by popularizing the correct pre hospital first aid method for snake bite in rural areas,going to hospital quickly,implementing the symptomatic treatment,and paying more attention to the functional ex

关 键 词：蛇伤性溃疡 防治 回顾分析 

分 类 号：R646[医药卫生—外科学]