蝮蛇咬伤局部组织坏死原因分析及中药内服外敷治疗

目的分析蝮蛇咬伤后局部组织坏死的原因,预防和治疗蛇伤性溃疡,降低致残率。方法 2003~2010年我院收治514例蝮蛇咬伤患者,对其中75例合并蛇伤性溃疡患者局部伤口的缚扎、血泡清除、切开排毒方法进行综合分析以及观察中药内服外敷的疗效。结果 514例蝮蛇咬伤患者中合并组织坏死75例,占14.59%;缚扎方法不当、过紧或时间过长,切开排毒,血泡处置不当均可引起或加重组织缺血和坏死;中药蛇伤解毒汤的内服与外敷可改善局部组织坏死。结论蝮蛇咬伤后的组织坏死原因复杂,正确的缚扎、血泡清除,不予切开排毒可降低组织坏死发生率;给予中药蛇伤解毒汤内服与外敷,对蛇伤溃疡有较好的疗效。

An Analysis of Causes for Local Tissue Necrosis by Viper Bites and Treatment of Internal and External Medicine

Objective To analyze the causes for local tissue necrosis by viper bites in order to prevent and better treat snakebite ulcer and reduce the rate of disability.Methods From 2003 to 2010,Suzhou Chinese Medical Hospital has received 75 patients bitten by vipers and with snakebite ulcer.The comprehensive analysis of the treatments including tying up local wounds,removing bloody foam and cutting the wounds to remove the toxins helps to observe the curative effect on internal and external medicine.Results The 75 patients out of the total 514 cases of viper bites had local tissue necrosis,accounting for 14.59%.The inappropriate tying up for too tight or too long,improper cutting and detoxification together with the removal of bloody foam may cause or aggravate tissue ischemia and necrosis.The application of internal and external medicine can ameliorate the necrosis.Conclusion The causes for local tissue necrosis by viper bites are complex.The combination of the appropriate tying up,removal of bloody foam and no cutting for detoxification can reduce the incidence rate of tissue necrosis.In addition,the treatment with internal and external medicine plays a positive role in curing snakebite ulcer.