竹叶青蛇咬伤凝血功能动态演变规律的探讨

摘要

Objective To review ihe pallern aboul ihe progressive evolvemenl for ihe laboralory index of coagulalion for Trimeresurus Slejnegeri bile cases. Methods The blood concenlralion of plalelel( PLT) , fibrinogen ( FBG) , as well as aclivaled parlial ihromboplaslin Lime ( APTT) and prolhrombin Lime(PT) were immedialely LesLed al visil Lime in 115 paLienLs biLLen by Trimeresurus sLejnegeri before any LreaLmenL. And Lhe daLa was alalyzed according Lo a differenL Lime from - biLLen - Lo - visiL. Results The sLudy reviewed LhaL PLT and FBG would progressively decline; PT and APTT would increase progressively, which mean iL would Lake longer in Lime Lo archive Lhe normal level; PT would increase noLiceably wiLhin 6 ~ 12 hours after Lhe incidenL and would reach iLs highesL level after 2 days; and APTT would increase obviously after 3 days. The sLudy also showed LhaL PLT would be lower Lhan normal 24 hours after being biLLen and would reach Lhe lowesL level in 4 days. FBG would be leveled under normal 12 hours after Lhe incidenL and would reach iLs lowesL level in 4 days as well. Conclusion The laboraLory index of coagulaLion for Trimeresurus sLejnegeri biLe cases varies progressively. The reviewed facLs from our research will be helpful for us Lo seL Lhe clinical LreaLmenL procedures, Lo esLimaLe Lhe duraLion of hospiLalizaLion for paLienLs of venomous snake biLLen, and Lo make diagnosis and prognosis correcLly.%目的 探讨竹叶青蛇咬伤患者凝血功能指标的动态演变规律.方法 115例竹叶青蛇咬伤患者,咬伤后就诊当时未经干预治疗前,采集血标本,检测血小板计数(PLT)、纤维蛋白原(FBG)、活化部分凝血活酶时间(APTT)及凝血酶原时间(PT).按照咬伤后不同的时间段进行分段统计分析.结果 PLT和FBG随发病时间的延长呈进行性下降,PT和APTT则进行性延长.其中,PLT在咬伤后24 h低于正常值,第4天达最低值;FBG在咬伤后12 h 低于正常值,第4天达最低值;PT于咬伤后6~12 h 明显延长,第2天达最高值;APTT于咬伤后第3天明显延长.结论 竹叶青蛇咬伤患者凝血功能指标随时间不同呈动态变化,可根据其变化规律来规范的预设毒蛇咬伤患者的住院时间,评估预后,指导临床治疗.