不同冷沉淀输注时间在蝮蛇毒诱发消耗性凝血病治疗中的临床效果  

Clinical effect on different cryoprecipitate infusion time in the treatment of venom-induced consumptive coagulopathy by Agkistrodon halys snakebite

作　　者：曾冰峰 蔡瑶 尹旺胜 ZENG Bingfeng;CAI Yao;YIN Wangsheng(Emergency Department,Qiannan Zhou Hospital of Traditional Chinese Medicine,Duyun City,Guizhou Province,558000,China)

机构地区：[1]贵州省黔南州中医医院急诊医学科,贵州都匀558000

出　　处：《蛇志》2025年第1期1-5,共5页Journal of Snake

基　　金：贵州省黔南州科技计划项目(项目名称:黔南州创伤救治临床医学研究中心,项目编号:黔南科合社字[2023]4号)。

摘　　要：目的观察不同冷沉淀输注时间对蝮蛇毒诱发消耗性凝血病(VICC)的临床效果。方法选取2020年1月至2023年12月在黔南州中医医院治疗的蝮蛇咬伤后诱发VICC的患者60例作为研究对象,随机分为对照组和观察组,每组30例。观察组在常规治疗基础上于24 h内输注冷沉淀,对照组在常规治疗基础上于24~48 h输注冷沉淀,比较两组患者治疗后第3天的凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、C反应蛋白(CRP)、白细胞(WBC)水平以及治疗后第3、7天的肿胀程度及视觉模拟评分法(VAS)评分,并对两组患者的住院时间、治疗费用进行比较。结果治疗前,两组患者的PT、TT、FIB、APTT、CRP、WBC及肿胀程度、VAS评分比较,差异均无统计学意义(均P>0.05);治疗后第3天,观察组的APTT、TT、PT、CRP、WBC水平均较对照组低,FIB水平较对照组高,差异均有统计学意义(均P<0.05)。治疗后第3、7天,观察组的肿胀程度和VAS评分均低于对照组,差异均有统计学意义(均P<0.05)。两组患者的住院时间和治疗费用比较,观察组的住院时间短于对照组,治疗费用低于对照组,差异均有统计学意义(均P<0.05)。结论蝮蛇咬伤后诱发的VICC建议在常规治疗上于24 h内联合输注冷沉淀治疗,可有效提高治疗效果,缩短住院时间。Objective To observe the clinical effect of different cryoprecipitate infusion time on wasting coagulation disease(VICC)induced by Agkistrodon halys snakebite.Methods Sixty patients with VICC induced by Agkistrodon halys snakebite treated in Qiannan ZhouHospital of Traditional Chinese Medicine from January 2020 to December 2023 were selected as the study objects and randomly divided into control group and observation group,with 30 cases in each group.Observation group received cryoprecipitate infusion within 24 h on the basis of conventional treatment,control group received cryoprecipitate infusion within 24~48 h on the basis of conventional treatment.The levels of prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),activated partial thromboplastin time(APTT),C-reactive protein(CRP)and white blood cell(WBC)on the 3rd day after treatment were compared between the two groups,as well as the swelling degree and visual analogue scale(VAS)score on the 3rd and 7th day after treatment.The hospitalization time and treatment cost of the two groups were compared.Results Before treatment,there were no significant differences in PT,TT,FIB,APTT,CRP,WBC,swelling degree and VAS scores between 2 groups(all P>0.05).On the 3rd day after treatment,the levels of APTT,TT,PT,CRP and WBC in observation group were lower than those in control group,and the level of FIB was higher,with statistical significance(all P<0.05).On the 3rd and 7th day after treatment,the swelling degree and VAS score of observation group were lower than those of control group,with statistical significance(all P<0.05).The hospitalization time and treatment cost of the two groups were shorter,and the treatment cost of the observation group was lower than that of the control group,with statistical significance(all P<0.05).Conclusion VICC induced by Agkistrodon halys snakebite is recommended to be combined with cryoprecipitate therapy within 24 h of conventional treatment,which can effectively improve the therapeutic effect,shorten the hospitalization time and red

关 键 词：蝮蛇咬伤 消耗性凝血病 冷沉淀 疗效观察 

分 类 号：R646[医药卫生—外科学]