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目的:探讨使用抗五步蛇毒血清联合输注新鲜血浆治疗对蛇咬伤患者凝血功能障碍的干预作用。方法:选取2013年1月-20l4年10月本院急诊留观及病房收治的蛇咬伤患者218例,就诊时间为咬伤后24小时内,其中46例蛇咬伤患者并发凝血功能异常,随机分为常规治疗组20例和抗五步蛇毒血清联合输注新鲜血浆组26例。记录所有患者的性别、年龄、治疗方法,每日监测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),比较两组治疗对患者的凝血功能相关指标恢复时间的比较。结果:两组治疗患者的PT、APTT、TT、FIB、均较治疗前有所改善,抗五步蛇毒血清联合输注新鲜血浆组凝血功能恢复正常平均时间为3.15±1.38天,常规治疗组恢复平均时间为9.9±1.97天,P<0.05,差异均具有统计学意义。结论:抗五步蛇蛇毒血清联合输注新鲜血浆组较常规治疗组凝血功能恢复时间明显缩短,明显减低患者全身出血和重要脏器出血风险。
Objective: To investigate the intervention effect of anti-five-step snake venom serum combined with infusion of fresh plasma on coagulation dysfunction in snakebite patients. Methods: A total of 218 cases of snake bites in our hospital from January 2013 to October 2014 were enrolled in this study. The treatment time was 24 hours after the bite. Among them, 46 cases of snake bite patients had coagulation abnormalities, Randomly divided into routine treatment group 20 cases and anti-five-step snake venom serum combined infusion of fresh plasma group of 26 patients. All patients were recorded for gender, age, treatment, daily monitoring of patients with prothrombin time (PT), activated partial thromboplastin time (APTT), plasma thrombin time (TT), fibrinogen (FIB) Comparison of recovery time of coagulation related index in two groups of patients on treatment. Results: The PT, APTT, TT and FIB of the two groups were all improved compared with those before treatment. The average recovery time of coagulation was 3.15 ± 1.38 days in the anti-five-step venom serum plus infusion fresh plasma group, The average time was 9.9 ± 1.97 days, P <0.05, the differences were statistically significant. Conclusion: Compared with the conventional treatment group, the recovery time of coagulation function was significantly shortened in the fresh plasma treated with anti-five-step snake venom serum, significantly reducing the risk of systemic hemorrhage and major organ bleeding in patients.