中华眼镜蛇咬伤的治疗进展  

Progress in the treatment of Chinese cobra bite

作　　者：罗璿 温凯 刘军廷[1] LUO Xuan;WEN Kai;LIU Junting(Department of Emergency,the First Affiliated Hospital of Guangxi Medical University,Nanning City,Guangxi Zhuang Autonomous Region,530021,China)

机构地区：[1]广西医科大学第一附属医院急诊科,广西南宁530021

出　　处：《蛇志》2024年第2期136-139,146,共5页Journal of Snake

摘　　要：中华眼镜蛇咬伤多见于中国东南部,主要表现为局部肿胀、疼痛和组织坏死。尽管传统内科治疗如使用抗蛇毒血清中和毒素,但对局部损伤恢复作用有限,往往需要外科干预治疗。院前处理包括快速识别、肢体制动、清洁伤口和迅速就医。院内治疗有清创术、局部负压封闭引流术(VSD)、植皮术和皮瓣移植术等治疗方法,以减少感染,促进创面修复和愈合。围手术期的对症支持、中医和功能康复治疗,对毒蛇咬伤患者的恢复有积极作用,可减少致残率和改善患者预后。Chinese cobra bites are common in southeastern China,mainly manifested as local swelling,pain,and tissue necrosis.Although traditional medical treatment such as using antivenom to neutralize toxins has limited effect on the recovery of local injuries,surgical intervention is often required.Pre-hospital treatment includes rapid identification,limb immobilization,wound cleaning,and prompt medical attention.In-hospital treatment includes debridement,local vacuum sealing drainage(VSD),skin grafting,and skin flap transplantation to reduce infection and promote wound repair and healing.Perioperative symptomatic support,traditional Chinese medicine,and functional rehabilitation therapy have positive effects on the recovery of snakebite patients,reducing the rate of disability and improving patient prognosis.

关 键 词：中华眼镜蛇 蛇咬伤 抗蛇毒血清 清创术 皮瓣移植术 

分 类 号：R646[医药卫生—外科学]