16例孕妇毒蛇咬伤的临床治疗和研究  

Clinical Study on Treatment Primary with Antivenom in 16 Cases Pregnant Women Bite by Snake

作　　者：陈康德[1] 张凑芳[1] 马军[1] 吴代强[1] 刘文锋[1] 邵华[1] 

机构地区：[1]浙江省磐安县人民医院,浙江磐安322300

出　　处：《蛇志》2004年第1期14-20,共7页Journal of Snake

摘　　要：目的　探讨抗蛇毒血清、蛇毒素对孕妇及胎儿的影响。　方法　将 193例蛇伤妇女随机分为 2组 ,孕妇组 (治疗组 ) 16例 ,非孕妇组 (对照组 ) 177例。两组均采用抗蛇毒血清、抗生素治疗。治疗组结合中药治疗 ,对照组配合激素 ,改善微循环及抗过敏药物治疗。防治血清反应措施 ,两组在用药时间和药物选择上均有严格区别。　结果　治疗组与对照组的治愈率分别为 87.50 % ( 14 /16 )和 89.83% ( 159/177) ;好转率分别为 12 .50 % ( 2 /16 )和 10 .17% ( 18/177)。两组临床疗效比较 ,差异均无显著性意义 ( P>0 .0 5)。治疗组与对照组的血清反应率分别为 12 .5% ( 2 /16 )和 1.6 9% ( 3/177)。两组血清反应率比较 ,治疗组明显高于对照组 ,差异有极显著性意义 ( P <0 .0 1)。治疗组中新生儿全部存活 ,无溶血性贫血 ,也未发现缺陷和畸形 ,各项生理指标均正常。　结论　临床证实 ,国产精制抗蛇毒血清制品纯度高、质量好、中和力强、副作用少 ,是治疗孕妇毒蛇咬伤的安全特效药物。孕妇抗生素的选择和抗过敏等药物的应用一定要坚持孕期用药的基本原则。Objective To explore the effects of the antivenom and snake venom on the pregnant women and the fetus Methods 193 patients were randomly divi ded into the control group(n=177) and the treated group(n=16) The treat e d group were all pregnant women and the control group were all non-pregnant wom e n They were both treated with antivenom and antibiotic Additionally, the treat ed group combine with Chinese Traditional Medicine, while the control group were treated with the hormone and the drugs that can improve the microcirculation an d aanti-anaphylaxis Result In the treated group, there were 14 cases to b e restored(87 5%) and 2 cases to turn for the better(12 5%) There were 159 ca se s to be restored (89 83%) and 18 cases to turn for the better (10 17%) in cont rol group The comparison of the clinical curative effect between two group hadn't obviously different(P>0 05) The serum reaction ra te in the treated group was 12 5% (2/16), the other was 1 69% (3/177) The com pa rison had significantly different (P<0 01) The newborn were all existed in the treated group and various kinds of physiological index were normal Con c lusion The method that use the antivenom to treat the snakebite pregnant is s afe and efficacious

关 键 词：孕妇 毒蛇 咬伤 治疗 抗菌药物 抗蛇毒血清 

分 类 号：R646[医药卫生—外科学]