通讯作者: 杨敏, zyyangmin@126.com

DOI：10.12201/bmr.202407.00060

Study on the Treatment of Coagulation Dysfunction and Limb Swelling after Bloodborne Venom Snake Bite with Hyperbaric Oxygen Combined with External Use of Snake Damage Powder

• 摘要：目的 研究高压氧联合蛇伤散对于血循毒蛇咬伤引起的凝血功能障碍以及肢体肿胀的治疗效果。方法 选取2021年4月至2023年10月本院收治的112例血循毒蛇咬伤患者随机分为常规治疗组、常规治疗+蛇伤散治疗组、常规治疗+高压氧治疗组和常规治疗+高压氧联合蛇伤散治疗组，每组包含患者各28例，常规治疗组进行常规治疗，常规治疗+蛇伤散治疗组在常规治疗基础上加用蛇伤散，常规治疗+高压氧治疗组在常规治疗基础上加用高压氧治疗，常规治疗+高压氧联合蛇伤散治疗组在常规治疗基础上联合高压氧以及蛇伤散外敷治疗。观察比较四组患肢与健侧肢体周径差、疼痛评分变化以及凝血功能（凝血酶原时间、凝血活酶时间、纤维蛋白原）的水平变化。结果 各组数据均符合正态分布。对于周径差比较，各组自身前后对照（P＜0.05），均有统计学意义。对于第三天周径差，常规治疗+高压氧联合蛇伤散治疗组与常规治疗组以及常规治+蛇伤散治疗组组均有统计学意义（P＜0.05）。第五天周径差各组之间均存在统计学意义（P＜0.05）。对比治疗后各组凝血功能(凝血酶原时间、凝血活酶时间、纤维蛋白原)情况，常规治疗+蛇伤散治疗组比较常规治疗组与常规治疗+高压氧治疗组有统计学意义（P＜0.05），常规治疗+高压氧联合蛇伤散治疗组比较其余三组有统计学意义（P＜0.05）。对于VAS疼痛评分，各组治疗前后均存在统计学意义（P＜0.05），治疗后各组之间均存在统计学意义（P＜0.05）。结论 高压氧在治疗血循毒蛇咬伤患者的肿胀、疼痛方面具有优势，外用自拟蛇伤散在改善凝血功能方面更有优势，高压氧联合外用自拟蛇伤散在改善凝血功能与肢体肿胀、疼痛方面有更好的疗效。

  关键词： 血循毒蛇咬伤；高压氧；外用蛇伤散

   

  Abstract: Objective Study on the therapeutic effect of hyperbaric oxygen combined with snake venom powder on coagulation dysfunction and limb swelling caused by bloodline venomous snake bites. Methods 112 patients with blood circulation venomous snake bites admitted to our hospital from April 2021 to October 2023 were randomly divided into a conventional treatment group, a conventional treatment+snake bite powder treatment group, a conventional treatment+hyperbaric oxygen treatment group, and a conventional treatment+hyperbaric oxygen combined with snake bite powder treatment group. Each group included 28 patients. The conventional treatment group received conventional treatment, while the conventional treatment+snake bite powder treatment group received snake bite powder in addition to conventional treatment. The conventional treatment+hyperbaric oxygen treatment group received hyperbaric oxygen treatment in addition to conventional treatment. The conventional treatment+hyperbaric oxygen combined with snake bite powder treatment group received hyperbaric oxygen and snake bite powder external application treatment in addition to conventional treatment. Observe and compare the circumference difference, pain score changes, and coagulation function (prothrombin time, thromboplastin time, fibrinogen) levels between the affected limb and the healthy limb in four groups. Results All data in each group follow a normal distribution. For the comparison of weekly diameter difference, there was a statistically significant difference between the groups before and after self comparison (P<0.05). For the difference in circumference on the third day, there was a statistically significant difference (P<0.05) between the conventional treatment+hyperbaric oxygen combined with snake wound powder treatment group and the conventional treatment group, as well as the conventional treatment+snake wound powder treatment group. On the fifth day, there was a statistically significant difference in weekly diameter between the groups (P<0.05). Comparing the coagulation function (prothrombin time, thromboplastin time, fibrinogen) of each group after treatment, there was a statistically significant difference (P<0.05) between the conventional treatment group and the conventional treatment+hyperbaric oxygen treatment group in the conventional treatment+snake injury powder treatment group, and a statistically significant difference (P<0.05) between the conventional treatment+hyperbaric oxygen combined with snake injury powder treatment group and the other three groups. For VAS pain scores, there was a statistically significant difference between the groups before and after treatment (P<0.05), and between the groups after treatment (P<0.05). Conclusion Hyperbaric oxygen has advantages in treating swelling and pain in patients with venomous snake bites, while topical self formulated snake venom powder has more advantages in improving coagulation function. The combination of hyperbaric oxygen and topical self formulated snake venom powder has better therapeutic effects in improving coagulation function and limb swelling and pain.

  Key words: Venomous snake bite；hyperbaric oxygen；External snakebite powder

  提交时间：2024-07-24

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• 序号	提交日期	编号	操作
  1	2024-06-29	bmr.202407.00060V1	下载

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