目的:探讨非出血倾向蛇咬伤患者的局部治疗。方法:将符合入选条件的120例患者随机分为切开组(A组)与保守组(B组),两组患者全身治疗方法相同。切开组患者给予局部皮肤切开排毒,以33%硫酸镁溶液湿敷患肢,保守组患者局部给予饱和盐水浸泡及33%硫酸镁溶液湿敷患肢,交替进行。比较两组患者脏器损伤、血肌红蛋白(Mb)水平、骨筋膜室综合征及感染发生情况、疼痛程度、住院时间的差异。结果:两组患者器官功能障碍、骨筋膜室综合征发生情况、血Mb水平无显著差异(P>0.05)。切开组患者疼痛程度及感染发生率显著高于保守组患者(P<0.05),且住院时间显著长于保守组(P<0.05)。结论:对于脏器损伤水平为轻型且无出血倾向的蛇咬伤无需将伤口切开引流,局部治疗可采用患肢的高渗液体浸泡与湿敷。 Objective: To investigate the local treatment of snakebite patients without hemorrhagic tendency. Methods: 120 eligible patients were randomly divided into incision group (A group) and conservative group (B group). The two groups of patients were treated with the same method of systemic treatment. Patients in the incision group were given local skin incision detoxification. The affected limbs were wet-coated with 33% magnesium sulfate solution. Patients in the conservative group were treated with saturated saline soaking and 33% magnesium sulfate solution wet-dressing limbs alternately. The differences of organ injury, Mb, osteofascial compartment syndrome and incidence of infection, pain and length of hospital stay were compared between the two groups. Results: There were no significant differences in organ dysfunction, compartment syndrome and blood Mb level between the two groups (P> 0.05). The patients in the incision group had significantly higher degree of pain and infection than those in the conservative group (P <0.05), and the hospitalization time was significantly longer than that in the conservative group (P <0.05). Conclusion: For the snake bites with light and bleeding-free lesions, there is no need for incision and drainage of the wounds. Local treatment may use hypertonic liquid immersion and wet dressing of limbs.