基于动物学、临床医学跨界研究快速准确诊断1例不明蛇类咬伤的分析  

A case report of rapid and accurate diagnosis of unidentified snake bite based on zoological and clinical medical cross-boundary research

作　　者：胡庆峰 罗毅[1,2] 雷卓异 翟崇宇 王琦 吴雪 HU Qing-feng;LUO Yi;LEI Zhuo-Yi;ZHAI Chong-yu;WANG Qi;WU Xue(Department of Emergency,Liuzhou People's Hospital/Snake Injury Treatment Base in Central and Northern Guangxi,Liuzhou City,Guangxi Zhuang Autonomous Region,545006,China;Department of Emergency,Liuzhou Traditional Chinese Medicine Hospital/Liuzhou Integrated Chinese and Western Medicine Snake Injury Treatment Center,Liuzhou City,Guangxi Zhuang Autonomous Region,545001,China)

机构地区：[1]柳州市人民医院急诊科/桂中桂北蛇伤救治基地,广西柳州545006 [2]柳州市中医医院急诊科/柳州市中西医结合蛇伤救治中心,广西柳州545001

出　　处：《蛇志》2021年第1期10-12,16,共4页Journal of Snake

基　　金：柳州市人民医院院内科研基金立项课题(编号:lry201901);柳州市科学研究与技术开发计划项目课题(2017BH20302);广西壮族自治区卫生健康委员会科研课题(编号:Z20200021);广西壮族自治区卫生健康委员会科研课题(编号:Z20200075);广西壮族自治区卫生健康委员会科研课题(编号:Z20200141)。

摘　　要：目的探讨动物学、临床医学跨界研究成果联合运用于快速准确诊断不明蛇类咬伤中的作用及效果。方法通过回顾性分析1例不明蛇类咬伤患者的临床资料,从病史、动物学生活习性、咬痕鉴别、流行病学、临床表现、蛇类动物学分布6个方面进行剖析不明蛇类咬伤的诊断思路与方法。结果该例蛇伤患者的病史特征以及诊断与鉴别诊断:(1)病史特征符合银环蛇生活习性;(2)咬痕特征首先符合毒蛇咬痕,其次与银环蛇咬痕特征高度吻合;(3)蛇伤流行病学研究支持被咬地域存在银环蛇致伤病种;(4)临床表现首先符合毒蛇咬伤,其次与银环蛇/金环蛇咬伤临床表现高度吻合;(5)依据桂中毒蛇种类分布研究成果结合银环蛇咬痕特征确诊为银环蛇咬伤。结论将蛇类动物学、临床医学跨界研究成果联合运用于不明蛇类咬伤的快速准确诊断是一种切实有效的方法。Objective Discussing the usage of an innovative diagnosing approach for unidentified snakebites-Zoology&Clinical Medicine Analysis.Methods In accordance with a retrospective case study of an unidentified snakebite at night,explaining the thought and method of diagnosing the unknown snakebite from the following six aspects in the fields of zoology and clinical medicine:medical history,different snakes’living habits,bite mark identification,epidemiology,clinical manifestations and zoology specialized in snakes.Results Firstly,the feature of patient’s medical history can be matched with the living habits of Bungarus multicinctus.Second,from the bite mark,it can be predicted that the snake is poisonous.Moreover,among the toxic snakes,the Bungarus multicinctus is again under highly suspicion.Thirdly,in the field of epidemiology,researches show that the vulnerant of Bungarus multicinctus exists at the place where the patient is bitten.Fourthly,according to the clinical manifestations,the scope of snakes has been narrowed down into two possibilities-Bungarus fasciatus and Bungarus multicinctus.In the end,basing on the snake distribution in Guizhong Region of Liucheng Village,where the patient gets bitten,it can be confirmed that the snakebite is caused by Bungarus multicinctus.Conclusion The essay shows that the Zoology&Clinical Medicine Analysis has great impact on the rapid and accurate diagnosis of unidentified snake bite.

关 键 词：不明蛇类咬伤 快速准确诊断 银环蛇 

分 类 号：R646[医药卫生—外科学]