首页|强化肢体功能康复集束化治疗策略在蝮蛇咬伤致肢体肿胀治疗中的效果研究

强化肢体功能康复集束化治疗策略在蝮蛇咬伤致肢体肿胀治疗中的效果研究

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目的:评估强化肢体功能康复集束化治疗策略在蝮蛇咬伤致肢体肿胀中的治疗效果.方法:选择2021年5月-2023年10月在该院住院的117例蝮蛇咬伤患者作为研究对象,按照是否接受强化肢体功能康复集束化治疗分为治疗组(58例)和对照组(59例).分别于治疗前及治疗后第24 h、72 h行血清肌酸激酶(creatine kinase,CK)及D-二聚体(D-Dimer,D-D)检测并记录患者肢体肿胀、疼痛评分等指标.通过随访记录患者患肢消肿、疼痛消失及功能恢复正常的具体时间.结果:两组患者临床基线资料差异无统计学意义(P>0.05).两组患者在治疗后CK及D-D水平均呈随时间推移而明显降低的趋势,差异有统计学意义(P<0.05);治疗组CK水平降低的程度显著高于对照组,差异有统计学意义(P<0.05).治疗组肢体周径差值及VAS评分在治疗后第24 h时即出现明显降低且与对照组之间差异有统计学意义(P<0.05),对照组在治疗后第72 h时出现降低.治疗组在患肢消肿及功能恢复所需时间上均显著低于对照组,差异有统计学意义(P<0.05);而两组在疼痛最终消失所需时间上差异无统计学意义(P>0.05).结论:蝮蛇咬伤患者在接受规范化蛇伤救治的同时,给予实施强化肢体功能康复集束化治疗策略,可有效促进肢体组织损伤恢复、肿胀消除并缓解疼痛感受、缩短功能恢复时间.
Study on the effect of intensive limb function rehabilitation treatment bundle on limb swelling caused by Agkistrodon bites
Objective:The object of this paper is to evaluate the effect of intensive limb function rehabilitation treatment bundle on limb swelling caused by Agkistrodon bites.Methods:One hundred and seventeen patients with Agkistrodon bite in our hospital from May 2021 to October 2023 were selected as the study objects,and di-vided into the treatment group(n=58)and the control group(n=59)according to whether they received inten-sive limb function rehabilitation treatment bundle.Serum creatine kinase(CK)and D-Dimer(D-D)were detected before treatment and 24 and 72 hours after treatment,and limb swelling and pain scores were recorded.By follow-ing up the patients,the specific time when swelling,pain disappeared and function recovery was documented.Re-sults:There was no significant differences in baseline clinical data between the two groups(P>0.05).The CK and D-D levels of patients in both groups showed an obvious decreasing trend over time after treatment,and the difference was statistically significant(P<0.05).The reduction of CK level in the treatment group was significant-ly higher than that in the control group,and the difference was statistically significant(P<0.05).The difference of limb circumference diameter and VAS score in the treatment group were significantly decreased at 24 hours af-ter treatment and showed significant difference from those in the control group(P<0.05)which showed a de-crease at 72 hours after treatment.The time required for detumescence and functional recovery of affected limbs in the treatment group was distinctly lower than that in the control group,and the difference was statistically signifi-cant(P<0.05).There was no obvious difference in the time of ache disappear between the two groups.Conclu-sion:The result suggests that on the basis of standardized treatment,intensive limb function rehabilitation treat-ment bundle can effectively promote the recovery of limb tissue injury,reduce swelling,relieve pain and shorten the time of functional recovery.

Agkistrodon bitestreatment bundle strategyfunction rehabilitationswelling of the limbs

朱明月、王文博、戴秋婷、张建波、刘双庆、赵晓东、果应菲

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解放军总医院第四医学中心急诊医学科(北京,100048)

联勤保障部队天津康复疗养中心

三峡大学第二临床附属医院心内科

蝮蛇咬伤 集束化治疗策略 功能康复 肢体肿胀

2024

临床急诊杂志
华中科技大学同济医学院

临床急诊杂志

CSTPCD
影响因子:0.652
ISSN:1009-5918
年,卷(期):2024.25(3)
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