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目的:探讨早期伤口切开对蝮蛇咬伤患者预后的影响。方法:回顾性分析安徽中医院大学第一附属医院急诊科2015-03-2016-09诊治的60例蝮蛇咬伤患者,根据患者致伤后6h内就诊我院时伤口切开与否,分为不切开组(31例)、切开组(29例),并对2组的临床指标包括局部肿胀评分、住院天数、炎症指标、心肌酶进行统计学分析。结果:2组治疗前肿胀程度比较无明显差异。2组治疗后第4天肿胀程度较治疗前减轻(P<0.05或P<0.01),并且切开组肿胀程度大于不切开组;不切开组住院天数少于切开组(P<0.05);2组炎症指标及心肌酶各指标在治疗前无明显差异。2组治疗后WBC、CRP、CK、CK-MB、肌红蛋白较治疗前明显下降(P<0.05或P<0.01),且不切开组治疗后WBC、CRP、CK、CK-MB、肌红蛋白水平优于切开组(P<0.05)。结论:蝮蛇咬伤后不宜行伤口切开。
Objective: To investigate the effect of early wound incision on the prognosis of viper snake bite patients. Methods: A retrospective analysis of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine Emergency Department 2015-03-2016-09 Diagnosis and treatment of 60 cases of viper patients, according to the patient within 6h after injury when visiting our hospital wound or not, The patients were divided into two groups (n = 31) and group C (n = 29). The clinical parameters of the two groups were analyzed including local swelling score, length of hospital stay, inflammation index and myocardial enzyme. Results: There was no significant difference in swelling between the two groups before treatment. The degree of swelling on the fourth day after treatment in the two groups was lower than that before treatment (P <0.05 or P <0.01), and the degree of swelling in the incision group was greater than that in the incision group; the length of hospitalization in the incision group was shorter than that in the incision group (P <0.05) ); There was no significant difference between the two indexes of inflammation and myocardial enzymes before treatment. The levels of WBC, CRP, CK, CK-MB and myoglobin in the two groups after treatment were significantly lower than those before treatment (P <0.05 or P <0.01) The hemoglobin level was better than that of incision group (P <0.05). Conclusion: Viper bites should not be wound incision.