摘要
目的 分析云南省普洱市毒蛇咬伤流行病学特点,为当地医疗机构抗蛇毒血清储备提供参考,为毒蛇咬伤的预防救治提供经验.方法 回顾性分析2018～2022 年我院收治的802 例毒蛇咬伤患者的临床资料,对患者年龄、性别、职业分布、咬伤部位、咬伤月份、毒蛇种类、就诊时间、严重程度及住院时间、地域分布情况进行归纳分析.结果 本研究患者的年龄主要集中在30～69 岁(624 例,占77.81%),以男性患者为主(465 例,占57.98%),致伤人群以务农者多见(627 例,占78.18%),咬伤部位上肢明显高于下肢(495 例,占61.72%),蛇咬伤高发季节主要在每年的6～9 月份(479 例,占59.73%).普洱地区致伤蛇种以竹叶青蛇为主(371 例,占46.26%),其次为蝮蛇(231 例,占28.8%),眼镜蛇(127 例,占15.84%).患者大多就诊时间≤24 h(703 例,占 87.66%),以轻症居多(734 例,占 91.52%),救治有效率为 99.75%,平均住院时间10.59 d.普洱市 9 县 1 区均有蛇伤发生,以思茅区的蛇伤患者最多(219 例,占27.31%).结论 普洱市毒蛇咬伤患者以中老年男性为主,毒蛇种类以竹叶青蛇、蝮蛇、眼镜蛇为主,大多发生在6～9 月份.各级医疗机构应结合普洱地区毒蛇咬伤流行病学特点,做好相应的抗蛇毒血清储备,加强蛇伤防治知识教育宣传,提高公众对蛇伤的认知和防范意识,构筑蛇伤防治体系,加大对蛇伤防治的临床和基础研究,从而有效降低毒蛇咬伤的发病率、致残率和死亡率.
Abstract
Objective To analyze the epidemiological characteristics of venomous snakebites in Pu'er City of Yunnan Province,to provide reference for the reserve of antivenom in local medical institutions,and to provide experience in the prevention and treatment of venomous snakebites.Methods The clinical data of 802 patients with venomous snake bites admitted to our hospital in 2018 to 2022 were retrospectively analyzed,and the age,gender,occupational distribution,bite location,bite month,venomous snake species,time of consultation,severity,length of hospitalization,and geographical distribution of patients were summarized.Results The age of the patients in this study was mainly concentrated in the age of 30 to 69 years old(624 cases,accounting for 77.81%),males were signif-icantly more than females(465cases,accountingfor57.98%),the injured population in this study was mainly farmers(627cases,accounting for 78.18%),the upper limb at the bite site was significantly higher than the lower limb(495 cases,accounting for 61.72%),the high incidence season of snakebite was mainly in June to September every year(479 cases,accounting for 59.73%),and the injured snake species in Pu'er area were mainly bamboo leaf green snakes(371 cases),accounting for 46.26%),followed by pitvipers(231 cases,accountingfor28.8%),andcobras(127 cases,accounting for15.84%).Most of the patients were treated for less than24 hours(703 cases,accounting for 87.66%),most of them were mild(734 cases,accounting for 91.52%),the effective rate of treatment was 99.75%,and the average length of hospital stay was 10.59 days.Snake injuries occurred in all 9 counties and 1 district of Pu'er City,and Simao District had the largest number of snake injuries(219 cases,accounting for 27.31%).Conclusion The venomous snake bite patients in Pu'er area are mainly middle aged and elderly men,and the venomous snake species are mainly bamboo leaf green snakes,pit vipers and cobras,most of which occur in June to September.Medical institutions at all levels should com-bine the epidemiological characteristics of snakebites in Pu'er area,make corresponding antivenom reserves,strengthen education and publicity on snake bite prevention and control,improve the public's awareness and prevention of snake bites,build a snake bite preven-tion and control system,and increase clinical and basic research on snake bite prevention and control,so as to effectively reduce the in-cidence,disability and mortality of snake bites.
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