重庆地区蛇咬伤后急救处理

目的：探讨重庆地区蛇咬伤的急救处理及分析治疗过程中凝血功能变化。方法回顾性分析我院2003年1月～2013年9月收治的1191例蛇咬伤患者（男性696例，女性495例；年龄16～81岁，平均45.2岁）临床表现、治疗情况、凝血功能变化及分泌物细菌培养等。结果重庆地区蛇咬伤以蝮蛇为主，轻型患者830例（69.69％），就诊时临床表现以患肢肿胀常见，占92.35％。五步蛇及眼镜蛇较蝮蛇导致凝血系统异常具有显著性差异（ P＜0.05）。咬伤溃疡创面分泌物行细菌加药敏试验培养率49.5％，细菌培养阳性率21.3％。结论我院蛇咬伤以蝮蛇咬伤常见，五步蛇及眼镜蛇等咬伤较少，但对凝血功能影响显著，需及早综合处理蛇伤，合理运用抗菌药物，提高防治水平。

Research of emergency treatment of snakebite in Chongqing

Objective To explore emergency treatment and the changes of coagulation function of snakebite in Chongqing.Methods Clinical data of 1,191 cases(696 males and 495 females aged from 16-81 years with an average age of 45.2 years) of snakebite admitted to our hospital from Jan.2003 to Sep.2013 were retrospectively an-alyzed with clinical manifestations,treatment,coagulation changes and bacterial culture of secretions.Results The main snakebite was caused by viper in Chongqing.Most of the patients(830 cases,69.69%) had mild symptoms a-mong which limb swelling was common,accounting for 92.35%.Bites by acutus and cobra caused significant ab-normal coagulation compared with viper ( P<0.05 ) . Bacterial culture with drug sensitive test of secretions from snakebite-caused ulcer made up for 49.5%,with a positive rate of 21.3%.Conclusion Viper bites were common in our hospital.Although acutus and cobra bites were less,the effect on blood coagulation function was significant. So we need an early comprehensive treatment of snakebites,rational use of antibacterial to improve prevention and treatment.