波动式负压封闭引流技术对中华眼镜蛇咬伤患者疗效的影响  

Influence of vacuum sealing drainage in wave suction on the curative effect of Chinese cobra bites

作　　者：刘路培[1] 龙春萍[1] 黄高宗 Liu Lupei;Long Chunping;Huang Gaozong(Department of Emergency,Liuzhou People's Hospital,Guangxi Zhuang Autonomous Region,Liuzhou 545006,China)

机构地区：[1]广西壮族自治区柳州市人民医院急诊科,545006

出　　处：《中国医药》2021年第3期444-447,共4页China Medicine

基　　金：广西壮族自治区卫生和计划生育委员会科研课题(Z20180298)。

摘　　要：目的研究波动式负压封闭引流(VSD)技术对中华眼镜蛇咬伤患者疗效的影响。方法选取2014年1月至2020年1月广西壮族自治区柳州市人民医院急诊科收治的200例中华眼镜蛇咬伤患者纳为研究对象。采用随机数字表法分为观察组与对照组,各100例。2组均接受早期程序化综合治疗,其中对照组在此基础上加用传统VSD,观察组加用波动式VSD,比较2组皮肤坏死积分、上肢肿胀程度和血清肌酸激酶、乳酸脱氢酶(LDH)、高敏C反应蛋白(hs-CRP)水平及治疗效果。结果治疗后2组皮肤组织坏死范围、坏死深度、水血疱情况及皮肤组织坏死总积分均低于治疗前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。治疗后2组伤肢肿胀程度均较治疗前显著减轻,且观察组显著轻于对照组,差异有统计学意义(P<0.05)。治疗72 h后,2组血清肌酸激酶及hs-CRP水平均达到顶峰,后逐渐下降,LDH值在治疗24 h后达到顶峰,后逐渐下降,且治疗24、72、96及120 h后,观察组血清肌酸激酶、LDH及hs-CRP水平均显著低于对照组(均P<0.05)。观察组总有效率高于对照组[100.0%(100/100)比93.0%(93/100)],差异有统计学意义(P<0.05)。结论波动式VSD能有效减轻中华眼镜蛇咬伤患者患肢肿胀,促进咬伤皮肤组织恢复,提高临床治疗效果。Objective To investigate the influence of vacuum sealing drainage(VSD)in wave suction on the curative effect of Chinese cobra bite.Methods From January 2014 to January 2020,200 patients with Chinese cobra bite admitted to Liuzhou People's Hospital,Guangxi Zhuang Autonomous Region were enrolled.They were randomly divided into observation group and control group with 100 cases in each group.On the basis of early programmed comprehensive treatment,traditional VSD was added to the control group,and VSD in waving suction was added to the observation group.The skin necrosis score,upper limb swelling degree,serum creatine kinase(CK),lactate dehydrogenase(LDH),high sensitivity C-reactive protein(hs-CRP)levels and treatment effects were compared between the two groups.Results After treatment,the necrotic range,necrotic depth,hydroblisters and total score of skin tissue necrosis in observation group were lower than those in control group(all P<0.05).After treatment,the degree of limb swelling in both groups were significantly less than that before treatment,and that in the observation group was significantly less than that in the control group(P<0.05).After 72 h of treatment,the levels of serum CK and hs-CRP in the two groups reached their peak and then gradually decreased.The LDH value reached the peak after 24 h of treatment,and then gradually decreased,and after 24,72,96 and 120 h of treatment,serum CK,LDH and hs-CRP levels in the observation group were significantly lower than those in the control group(all P<0.05).The total effective rate of observation group was higher than that of control group[100.0%(100/100)vs 93.0%(93/100)](P<0.05).Conclusion Application of VSD in waving suction can effectively alleviate the swelling,promote the recovery of patients'skin and improve the clinical curative effect of Chinese cobra bite.

关 键 词：中华眼镜蛇咬伤 波动式负压封闭引流技术 肌酸激酶 乳酸脱氢酶 高敏C反应蛋白 

分 类 号：R595.8[医药卫生—内科学]