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目的探讨抗蝮蛇毒血清的使用以及其输注时间对患者凝血功能的影响。方法回顾性收集2013年4月1日-11月30日首诊于急诊科的蝮蛇咬伤患者的临床资料,根据其过敏试验结果将所有患者分为皮试阴性组和皮试阳性组。再根据两组患者输注抗蝮蛇毒血清时间的长短,将阴性组患者分为输液时间≤1.5 h组和>1.5 h组;阳性组患者分为输液时间≤3 h组和>3 h组;记录所有患者的性别、年龄、输注时间、以及输注抗蝮蛇毒血清前后患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)纤维蛋白原(FIB)、D-二聚体(D-Dimer)等指标的情况。比较输注抗蝮蛇毒血清前后以及不同输注时间对患者的凝血功能相关指标的影响。结果阴性组和阳性组输注抗蝮蛇毒血清治疗后,患者的PT、APTT、TT、FIB、D-Dimer均较输注前有所改善,差异均具有统计学意义,输液时间≤1.5 h组和≤3 h组分别较输液时间>1.5 h组和>3 h组患者的上述凝血功能相关纠正更明显,差异有统计学意义(P<0.05)。结论抗蝮蛇毒血清能够纠正蛇咬伤患者凝血功能,且输注速度越快对凝血功能的改善效果更明显。
Objective To investigate the use of anti-snake venom serum and the effect of infusion time on the coagulation function of patients. Methods Retrospectively collected the clinical data of viper patients who were first diagnosed in the emergency department from April 1, 2013 to November 30, 2013. All the patients were divided into skin test negative group and skin test positive group according to the results of their allergy test. According to the duration of infusion of anti-snake venom serum in both groups, the patients in the negative group were divided into infusion time≤1.5 h and> 1.5 h; the patients in positive group were divided into infusion time≤3 h and> 3 h; All patients were recorded sex, age, infusion time and prothrombin time (PT), activated partial thromboplastin time (APTT), plasma thrombin time (TT) fibrinogen (FIB), D-dimer (D-Dimer) and other indicators of the situation. The effects of infusion of anti-Agkistrodon acutivirus serum before and after the infusion and different infusion times on coagulation-related indexes in patients were compared. Results In the negative group and the positive group, PT, APTT, TT, FIB and D-Dimer were all improved after infusion of anti-snake venom serum, the difference was statistically significant, infusion time ≤1.5 h group Correlation with coagulation function in patients with ≤3 h group were more significant than those with infusion time> 1.5 h and> 3 h respectively (P <0.05). Conclusion Anti-snake venom serum can correct the snakebite patients coagulation function, and infusion faster coagulation function to improve the effect is more obvious.