摘要
目的探讨波动式负压封闭引流术与传统负压封闭引流术(VSD)对中华眼镜蛇咬伤的治疗效果。方法选取中华眼镜蛇咬伤病人120例,随机分为治疗组与对照组,每组各60例。两组病人均早期给予程序化综合治疗,对照组应用传统VSD治疗,治疗组使用波动式负压封闭引流治疗。对两组病人的治疗效果进行比较分析。结果两组病人治疗前皮肤组织坏死积分、伤肢肿胀程度及肌酸激酶(CK)、乳酸脱氢酶(LDH)、超敏C反应蛋白(hs-CRP)各项指标比较差异均无统计学意义(P>0.05)。治疗后1~5 d两组病人皮肤组织坏死积分及伤肢肿胀程度均得到改善(F=162.935、238.084,Wald χ^(2)=122.335、164.635,P<0.05),但治疗组皮肤组织坏死积分在第3天开始效果显著提升(F=33.570~238.548,P<0.05),伤肢肿胀程度的效果也更显著(Wald χ^(2)=6.892~8.352,P<0.05)。治疗后第3天开始两组CK、LDH、hs-CRP水平开始下降,但治疗组效果更显著(F=38.863~562.686,P<0.05)。对照组有效率为73.33%,显著低于治疗组的93.33%(χ^(2)=6.793,P<0.05)。结论波动式负压封闭引流术对中华眼镜蛇咬伤病人的疗效优于VSD。
Objective To investigate the therapeutic effect of vacuum sealing drainage(VSD)in wave suction versus traditional VSD in the treatment of Naja atra bites.Methods A total of 120 patients with Naja atra bite were randomly divided into treatment group and control group,with 60 patients in each group.In addition to programmed comprehensive treatment,the patients in the control group were treated with traditional VSD,and those in the treatment group were treated with VSD in wave suction.Treatment outcome was compared between the two groups.Results Before treatment,there were no significant diff-erences between the two groups in skin necrosis score,degree of swelling in the injured limb,creatine kinase(CK),lactate dehydrogenase(LDH),and high-sensitivity C-reactive protein(hs-CRP)(P>0.05).On days 1-5 after treatment,both groups had significant improvements in skin necrosis score and degree of swelling in the injured limb(F=162.935,238.084;Waldχ^(2)=122.335,164.635;P<0.05),but since day 3,the treatment group had significantly greater improvements in skin necrosis score(F=33.570-238.548,P<0.05)and degree of swelling in the injured limb(Waldχ^(2)=6.892-8.352,P<0.05).Since day 3 after treatment,the levels of CK,LDH,and hs-CRP began to decrease in both groups,and the treatment group had significantly greater reductions than the control group(F=38.863-562.686,P<0.05).The control group had a significantly lower response rate than the treatment group(73.33%vs 93.33%,χ^(2)=6.793,P<0.05).Conclusion VSD in wave suction has a better therapeutic effect than traditional VSD in the treatment of Naja atra bites.
作者
刘路培
杨伟燕
毛文雄
LIU Lupei;YANG Weiyan;MAO Wenxiong(Department of Emergency Medicine, Liuzhou People’s Hospital, Liuzhou 545000, China)
出处
《青岛大学学报（医学版）》
2021年第6期915-918,共4页
Journal of Qingdao University(Medical Sciences)
基金
广西壮族自治区卫生和计划生育委员会科研课题(Z20180298)。
