小切口负压治疗对毒蛇咬伤后肢体肿胀及炎症反应的影响

发布时间：2018-03-11 07:11

本文选题：毒蛇咬伤　切入点：小切口　出处：《第三军医大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的研究多个小切口联合负压治疗对毒蛇咬伤后肿胀消退和炎症反应的影响。方法选择2015年4月至2016年7月我科收治的毒蛇咬伤患者29例,其中男性18例,女性11例,年龄18~70岁,用随机数字法将研究对象分为对照组和观察组(注册号:Chi CTR-TRC-14004189)。对照组采用传统综合治疗,观察组行患肢近端皮肤多个小切口手术后予以负压吸引,同时采用传统综合治疗。分别在治疗前(0 h),治疗后6、12、24、48、72 h 6个时间点,测量并计算患肢近端、中部、远端肢体周径与健侧对应部位肢体周径差值,同时测血清IL-6和TNF-α浓度,记录平均住院时间。结果不同时间下测量的观察组与对照组肢体周径差值差异有统计学意义,观察组小于对照组(P0.05);在不同测量时间下对照组与观察组IL-6与TNF-α浓度差异有统计学意义(P0.05),观察组低于对照组;两组平均住院时间差异有统计学意义(P=0.001),观察组少于对照组[观察组(5.43±1.07)d,对照组(7.67±1.95)d]。结论毒蛇咬伤后在传统综合治疗基础上采用小切口负压治疗可有效控制肿胀,加速肿胀消退,减轻全身炎症反应,缩短住院时间。
[Abstract]:Objective to study the effect of multiple small incision combined with negative pressure therapy on swelling and inflammation after venomous snake bite. Methods 29 patients with venomous snake bite were selected from April 2015 to July 2016, including 18 males and 11 females. Aged 1870 years, the subjects were divided into control group and observation group (registration number: 1: Chi CTR-TRC-14004 1899). The control group was treated with traditional comprehensive therapy, and the observation group received several small incision operations on the proximal skin of the affected limb to attract negative pressure. At the same time, the traditional comprehensive therapy was used. The difference of circumference diameter between the proximal and middle extremities and the corresponding parts of the contralateral limbs were measured and calculated at 6 time points, 6 hours before treatment and 6 hours after treatment. The serum concentrations of IL-6 and TNF- 伪 were measured at the same time, and the difference between the peripheral diameter of the distal extremity and the corresponding part of the contralateral extremity was measured, and the serum IL-6 and TNF- 伪 concentrations were measured. Results the difference of circumference between observation group and control group was statistically significant. The concentration of IL-6 and TNF- 伪 in the observation group was significantly lower than that in the control group (P 0.05), and was lower in the observation group than in the control group. The difference of average hospitalization time between the two groups was statistically significant, and the observation group was less than the control group [the observation group was 5.43 卤1.07 days, the control group was 7.67 卤1.95 days]. Conclusion the small incision negative pressure therapy after snake bite can effectively control the swelling and accelerate the swelling regression. Reduce systemic inflammatory reaction and shorten hospital stay.
【作者单位】：第三军医大学西南医院急救部;
【基金】：重庆市科技惠民计划项目(CSTC2013jcsfc10001-4) 第三军医大学临床创新基金(SWH2013LC11)~~
【分类号】：R646

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