眼镜蛇咬伤后预防性抗生素治疗对咬伤部位感染的影响研究  

Effect of prophylactic antibiotic therapy on bite site infection after cobra bite

作　　者：凌洪奖 农凯 陆艳建 潘陆 农剑锋 LING Hongjiang;NONG Kai;LU Yanjian;PAN Lu;NONG Jianfeng(Emergency Department,Pingguo People's Hospital,Pingguo City,Guangxi Zhuang autonomous region,531499,China;Emergency Department,Pingguo Maternal and Child Health Hospital,Pingguo City,Guangxi Zhuang autonomous region,531499,China)

机构地区：[1]广西壮族自治区平果市人民医院急诊科,广西平果531499 [2]广西壮族自治区平果市妇幼保健院急诊科,广西平果531499

出　　处：《蛇志》2024年第1期21-23,共3页Journal of Snake

摘　　要：目的研究眼镜蛇咬伤后预防性使用抗生素治疗对咬伤部位感染的影响。方法选取2020年1月1日至2022年12月1日我院收治的眼镜蛇咬伤中毒患者37例,随机分为对照组17例和观察组20例。对照组给予常规治疗,包括抗眼镜蛇毒血清、地塞米松磷酸钠、破伤风抗毒素、伤口清创以及负压封闭引流等。观察组在常规治疗的基础上给予预防性抗生素治疗,即给予静脉滴注左氧氟沙星氯化钠注射液进行预防,连续应用3 d。观察比较两组患者的外周血白细胞计数、C反应蛋白、降钙素原、伤口细菌阳性率、伤口化脓率和发热情况。结果治疗前,两组患者的白细胞计数、C反应蛋白、降钙素原水平比较,差异无统计学意义(均P>0.05);治疗1周后,对照组的白细胞计数、C反应蛋白、降钙素原均高于观察组,差异均有统计学意义(均P<0.05)。对照组的细菌阳性率和伤口化脓率及发热发生率均高于观察组,差异均有统计学意义(均P<0.05)。结论早期预防性使用抗生素有助于减少眼镜蛇咬伤局部的感染。Objective To study the effect of prophylactic antibiotic therapy on bite site infection after cobra bite.Methods Thirty-seven patients with cobra bite poisoning treated in our hospital from January 1,2020 to December 1,2022 were randomly divided into control group(n=17)and observation group(n=20).The control group was given routine treatment,including antivenom,dexamethasone sodium phosphate,tetanus antitoxin,wound debridement and negative pressure closed drainage.The observation group was given prophylactic antibiotics based on routine treatment,that is,intravenous drip of levofloxacin and sodium chloride injection for prevention for 3 days.The peripheral blood leukocyte count,C-reactive protein,procalcitonin,wound bacterial positive rate,wound suppurative rate and fever were observed and compared between the two groups.Results Before treatment,there were no significant differences in white blood cell count,C-reactive protein and procalcitonin levels between the two groups(P>0.05).After a week of treatment,the white blood cell count,C-reactive protein and procalcitonin in the control group were higher than those in the observation group,were statistically significant(all P<0.05).The bacterial positive rate,wound pyosis rate and fever rate in control group were higher than those in observation group,were statistically significant(all P<0.05).Conclusion Early prophylactic use of levofloxacin helps to reduce local infection in cobra bites.

关 键 词：眼镜蛇 蛇伤 预防性抗生素治疗 感染 

分 类 号：R646[医药卫生—外科学]