中国东南部杭州一家三甲医院就诊的蛇咬伤患者的临床特征

Yuchen Shen, Sipin Hu, Shuhua Bao, Mengyun Tu
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摘要

研究背景 毒蛇咬伤在中国是一个被忽视的重要公共卫生问题,迄今为止很少有研究关注这一问题。本研究旨在调查中国东南部杭州一家三级甲等医院的蛇咬伤患者的临床特征。方法 本回顾性研究共纳入 416 例蛇咬伤病例。研究数据来自病历,包括人口统计学、临床表现、处理和结果。结果 416 名毒蛇咬伤患者中有 248 名男性,平均年龄为 54.6 岁。大多数病例发生在 5 月至 9 月的农村地区。在所有被毒蛇咬伤的病例中,蝮蛇所占比例最高(55.3%)。手部是最容易被蛇咬伤的部位(47.4%)。患者的临床表现为疼痛(100%)、肿胀(100%)、伤口坏死(25.7%)、出血性水疱(18.3%)和水疱(8.7%)。392 名患者接受了抗蛇毒血清治疗,大多数患者在被咬后 6 小时内接受了治疗。26 名患者接受了手术治疗,90 名患者出现了毒液引起的消耗性凝血病。本研究中无死亡病例。结论 杭州是中国蛇咬伤高发地区之一。本研究的结果将有助于进一步了解杭州地区毒蛇咬伤的临床特征。
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Clinical characteristics of snakebite patients attending a tertiary hospital in Hangzhou, southeast China
Background Venomous snakebite is a neglected yet an important public health problem in China, and few studies have focused on them so far. The aim of this study is to investigate clinical characteristics of snakebites patients in a tertiary hospital in Hangzhou, southeast China. Methods A total of 416 snakebite cases were included in this retrospective study. The data were collected from the medical records including demographics, clinical manifestations, management and outcomes. Results Of the 416 patients with venomous snakebites, 248 were male, and the average age was 54.6 years. The majority of cases occurred in rural in May to September. Out of all the venomous bites, Gloydius brevicaudus accounted for the highest percentage (55.3%). Hands were the most vulnerable site to snakebites (47.4%). Patients had clinical manifestations of pain (100%), swelling (100%), wound necrosis (25.7%), hemorrhagic blister (18.3%), and blister (8.7%). Three hundred and ninety-two patients received antivenom administration, and most were treated within six hours after bites. Twenty-six patients received surgical treatments, and 90 patients developed venom-induced consumption coagulopathy. No deaths have occurred in this study. Conclusion Hangzhou is one of the regions with high affecting of snakebites in China. The results of this study will increase the understanding of the clinical characteristics of venomous snakebites in Hangzhou area.
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