| 刘莎,韩宁林.中西医结合治疗毒蛇咬伤疗效分析[J].安徽医药,2016,20(3):555-558. |
| 中西医结合治疗毒蛇咬伤疗效分析 |
| Effect analysis of the combined treatment of traditional Chinese and western medicine for snakebite |
| 投稿时间：2015-11-17 |
| DOI： |
| 中文关键词: 毒蛇咬伤 中西医结合 病情轻重 Logistic回归 |
| 英文关键词: snakebite combined treatment of traditional Chinese and Western Medicine severity of disease Logistic regression |
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| 中文摘要: |
| 目的 观察中西结合治疗毒蛇咬伤的方法和疗效,分析与其病情轻重及病程长短相关的指标,为临床诊治提供理论依据。方法 回顾性分析2013年4月至2014年11月安徽中医药大学第一附属医院急诊科收治的232例毒蛇咬伤患者,根据患者入院第5天复查的肝酶、心肌酶、肾功能、凝血功能、炎症指标情况分为治愈组 (151例)、好转组(81例),对其临床资料进行统计学分析。结果 住院第5天,232例住院患者的肝酶、心肌酶、肾功能、凝血功能、炎症指标均恢复正常或明显下降,没有患者遗留有器官功能障碍。与治愈组患者比较,好转组患者入院24 h的丙氨酸氨基转移酶(ALT)、尿素氮(BUN)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、总胆红素(TIBL)、白细胞计数(WBC) (P＜0.05)增高明显；进一步Logistic 回归分析显示:年龄(>60岁)、丙氨酸氨基转移酶(>50 U·L-1)、肌酸激酶同工酶(>24 U·L-1)升高是影响毒蛇咬伤患者疗程及疗效的独立预报因子(均P＜0.05)。结论 年龄、丙氨酸氨基转移酶、肌酸激酶同工酶,可作为临床预判毒蛇咬伤患者病情轻重及疗程长短的有价值指标。 |
| 英文摘要: |
| Objective To observe the therapeutic measures and curative effect of the combined treatment of Chinese and Western Medicine for snakebite patients and to examine the indicators of the severity and duration of disease so as to provide theoretical basis for clinical diagnosis and treatment.Methods We retrospectively analyzed the data of 232 snakebite patients who received treatment in the Emergency Department of The First Affiliated Hospital of Anhui University of Chinese Medicine during April 2013 and November 2014. Patients were assigned into cure group (n=151) and better group (n=81) according to the results of liver enzymes,myocardial enzymes,renal function,blood coagulation function,and inflammation index on the fifth day after admission. Statistical analysis was made of clinical data.Results On the fifth day after admission,liver enzymes,myocardial enzymes,renal function,blood coagulation function,inflammation indexes of 232 cases were back to normal level or significantly decreased,and organ dysfunction occurred in none of the cases. In comparison with patients in cure group,the alanine aminotransferase (ALT),urea nitrogen (BUN),creatine kinase (CK),creatine kinase isoenzyme (CK-MB),total bilirubin (TIBL),white blood cell count (WBC) (P<0.05) of patients in better group were increased significantly in 24 hours. The results of further Logistic regression analysis showed that age(>60 years old) ,increasing alanine aminotransferase (> 50 U·L-1) and increasing creatine kinase isoenzyme(>24 U·L-1) were independent predictors of the degree and duration of disease in snakebite patients (all P<0.05).Conclusions The results of this study suggest that age,alanine aminotransferase and creatine kinase isoenzyme are valuable indicators for severity and duration of snakebite in clinical prognosis. |
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