竹叶青蛇咬伤所致的功能障碍及诊疗策略进展  

Functional impairment caused by the bite of Trimeresurus stejnegeri snake and the progress of diagnosis and treatment strategies

作　　者：高琴芬 张玮[2] 马静怡 张艺馨 Gao Qinfen;Zhang Wei;Ma Jingyi;Zhang Yixin(Emergency Internal Medicine/EICU,Yunnan First People′s Hospital,the Affiliated Hospital of Kunming University of Science and Technology,Kunming 650000,China)

机构地区：[1]云南省第一人民医院昆明理工大学附属医院急诊内科/EICU,云南昆明650000 [2]昆明医科大学第一附属医院重症医学科,云南昆明650000 [3]勐海县人民医院,云南西双版纳666100 [4]云南省第一人民医院急诊重症医学科,云南昆明650000

出　　处：《中国急救医学》2025年第4期359-364,共6页Chinese Journal of Critical Care Medicine

基　　金：睿E(睿意)急诊医学研究专项基金。

摘　　要：蛇咬伤是基层急诊科常见的中毒事件,每年约有数十万人遭受毒蛇咬伤,其中70%以上是青壮年,给社会和家庭带来沉重负担。竹叶青(Trimeresurus stejnegeri)蛇是常见的血液毒蛇,被其咬伤后主要表现为出凝血功能障碍及多器官功能障碍,致死、致残率高。目前尚缺乏快速、高效鉴别毒蛇咬伤的检测方法,主要依靠患者病史、临床表现及实验室检查等进行诊断,治疗的主要策略为使用相应的抗蛇毒血清。现就近年来竹叶青蛇咬伤的中毒机制及临床诊治新进展作一综述,以期能够为临床诊疗提供参考。Snakebites are a common poisoning incident in primary emergency departments,and about hundreds of thousands of people suffer from venomous snakebites every year,more than 70%of whom are young adults,which brings a heavy burden to society and families.Trimeresurus stejnegeri is a common blood venomous snake.The main symptoms are coagulation dysfunction and multiple organ dysfunction after being bitten by it,with a high mortality and disability rate.At present,there is a lack of rapid and efficient detection methods to identify venomous snakebites,and the diagnosis mainly depends on the patient′s medical history,clinical manifestations and laboratory tests.The mainstay of treatment is the use of appropriate antivenoms.This article reviews the poisoning mechanism and new progress in clinical diagnosis and treatment of Trimeresurus stejnegeri snake bites in recent years,so as to provide reference for clinical diagnosis and treatment.

关 键 词：竹叶青蛇 中毒机制 诊断 救治 出凝血功能障碍 多器官功能障碍 抗蛇毒血清 中医药 

分 类 号：R47[医药卫生—护理学]