竹叶青蛇咬伤的流行病学调查及院前影响因素分析

目的:研究竹叶青蛇咬伤的流行病学特征及首诊患者病情轻重程度的影响因素,为竹叶青蛇咬伤的预防及控制院前中毒进展提供依据。方法:回顾性地收集2012-12-01—2017-12-01期间就诊于深圳市中医院蛇伤中心的593例竹叶青蛇咬伤患者信息,分析其流行病学特征;同时以纳排标准从中筛选出460例患者,通过组间比较及二分类多元Logistic回归模型,分析竹叶青蛇咬伤患者首诊病情轻重程度的影响因素,并对构成影响的部分因素绘制ROC曲线,找出最佳cutoff值。结果:竹叶青蛇咬伤主要发生在夏秋两季,夜间多发,高发人群是中青年男性,高发地点是在户外;单因素分析结果显示受伤后到院时间的组间比较差异有统计学意义(P=0.003);多因素分析结果显示咬伤后到院的时间长短是患者首诊病情轻重程度的独立危险因素(OR=1.022,95%CI:1.011～1.032),患肢近端结扎是有利影响因素(OR=0.553,95%CI:0.311～0.985);ROC曲线显示咬伤后到院时间有预测价值(AUC=0.613),cutoff值为22 h。结论:深圳市及周边地区竹叶青蛇咬伤多发生在夏秋两季,夜间多发,高发人群是中青年男性,高发地点是户外;被竹叶青蛇咬伤后越久到专业医院采取有效治疗,其病情越严重,病情加重的时间窗为22 h;咬伤后院前予患肢近端结扎,能有效减轻到院病情严重程度,而院前进行伤口冲洗并没有对患者到院病情显示出有利作用。     

狂犬病防制的新进展

狂犬病防制的新进展湖南省衡山县卫生防疫站（４２１３００）曾林生狂犬病是人畜共患疾病。目前由于缺乏有效疗法，病死率极高，严重他威胁人类生命。近百年来，人们对狂犬病采取了许多措施，特别是５０年代以来，许多国家进行了以免疫犬为主的措施，对控制狂犬病起到了重...     

肾气丸加减治疗AECOPD肺肾两虚型临床疗效观察

目的探讨肾气丸加减治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法将60例COPD急性加重期患者随机分成两组,治疗组30例予常规西医治疗联合肾气丸加减治疗,对照组30例予单纯西医治疗。结果治疗组与对照组相比,能改善临床症状,改善肺功能,出院天数也明显减少。结论肾气丸加减治疗AECOPD疗效显著。     

口服碘油胶丸引起过敏反应54例临床分析

衡山县福田乡1981年普查地方性甲状腺肿(简称地甲病),共查12057人,发现地甲病患者463例,患病率3.84%。1986年5月22日至5月28日对该乡居民口服碘油胶丸防治地甲病,共服药11277人,出现碘过敏反应者120例,反应率1.06%。现将资料较全的54例     

卡介苗接种致局部脓疡与淋巴结肿大的防治

接种卡介苗后的异常反应以局部化脓与淋巴结肿大化脓为常见。1岁以内的婴儿,常在接种卡介苗1～2个月内形成局部脓疡或淋巴结肿大(颈部、锁骨下、腋窝部多见),直径超过1cm,可继续发展成脓肿和溃破,2～3个月不消退,时间长的可达1年以上。个别的可形成瘘管经久不愈。鉴于基层医生遇见上述异常反应感到十分棘手,为此,笔者参阅文献资料,就有关问题综述如下,供同道参考。     

麻疹控制与消除几个问题的榷商

从就麻疹控制与消除标准，有利条件，不利因素、措施及要注重的问题，有待解决的重要理论与实际问题作了讨论。     

煤烟污染型氟区室内空气氟浓度与人群血、唾液氟含量的关系

煤烟污染型氟区为居民在室内敞燃火,煤烟污染室内空气所致。有关室内空气氟浓度与人群血、唾液氟的关系,国内外未见报道。本文就煤烟污染型氟浓度与人群的血、唾液氟含量关系加以探讨。材料方法选择敞炉烧煤取暖、烤粮的高寒山区村屯为观察点。以生活习惯和生活水平与观察点相同,以烧柴取暖、烤粮村屯为对照点。观察点和对照点的全     

阿是穴针刺放血治疗蛇伤局部肿痛临床疗效观察

ObjectiveTo evaluate the clinical therapeutic effect of acupuncture bloodletting therapy on local swelling and pain of snakebite in the patients bitten by snakes.MethodsA total of 106 patients with trimeresurus stejnegeri bite were randomly divided into two groups, a conventional treatment group and a conventional treatment combined with bloodletting therapy group, 53 cases in each one. In the conventional treatment group, the convention treatment of western medicine was adopted. In the conventional treatment combined with bloodletting therapy group, on the base of the conventional treatment, bloodletting therapy was applied at Ashi points selected at the tender points around the wound. The intervention and observation were performed not less than 7 days in two groups. Before and after treatment, swelling and pain degrees were measured and remission time of both the limb swelling and pain were recorded in the patients.ResultsCompared with the values on day 1 of treatment, swelling degree and visual analogue scale (VAS) score of the upper and lower limbs were all lower on day 3 and day 7 of treatment in the patients of the two groups (all P < 0.05). Compared with the conventional treatment group, swelling degree and VAS score of the upper and lower limbs were all lower in the values of the conventional treatment combined with bloodletting therapy group on day 3 and day 7 of treatment respectively (all P < 0.05). The remission time of either limb swelling or pain in the patients of the conventional treatment combined with bloodletting therapy group was shorter than the conventional treatment group respectively (both P < 0.05).ConclusionAcupuncture bloodletting therapy can effectively relieve the local swelling and pain caused by snakebite, promote the recovery of limb function, shorten the treatment course and improve the clinical therapeutic effect.