血循毒蛇咬伤肌酸激酶干预研究

目的观察甘露醇对血循毒蛇咬伤患者肌酸激酶(CK)值的影响,降低和预防横纹肌溶解症及骨筋膜室综合征的发生率。方法将我院2009~2013年血循毒蛇咬伤住院患者104例随机分成两组,A组(观察组)患者入院后3h内开始使用甘露醇125~250ml每12h1次输注作CK预处理;B组(对照组)未使用甘露醇。观察比较两组CK值差异、横纹肌溶解症及骨筋膜室综合征发生率、平均住院天数。结果 A组CK值水平明显低于B组(P0.05);横纹肌溶解症发生率为5%、骨筋膜室综合征发生率为0%、平均住院天数为4.78天,明显低于B组的20.45%、4.55%和6.89天,差异有统计学意义。结论使用甘露醇对CK干预是减少及预防血循毒蛇咬伤后横纹肌溶解症及骨筋膜室综合征的有效措施,对血循毒蛇咬伤无明显禁忌证的患者甘露醇可以常规使用。

Research on Intervention Creatine Kinase of Blood Circulation Poison in Snake Bitten

Objective To study the blood circulation poison in the patients bitten by snake on the effects of CK value of the use of mannitol ,thereby reducing the incidence and prevention of rhabdomyolysis and osteofascial com-partment syndrome . Methods In our hospital during 2009~2013 blood circulation of snakebite patients cases , were randomly divided into A ,B two groups ,the CK continues at a low level ,in the A group within 3 hours after admission to start using mannitol 125~250 ml of a 12 hour infusion of CK preconditioning ,group B as control group did not use mannitol ,by monitoring the CK value ,the incidence of statistical rhabdomyolysis and osteofascial compartment syndrome ,statistics the average hospitalization days ,comparison of A ,B two groups of CK values , compared the incidence of A ,B two groups of rhabdomyolysis and osteofascial compartment syndrome ,compared two groups of average hospitalization days difference . Results A group had CK values increased level was sig-nificantly lower than that in B group （P＆lt;0.05） ,A ,B two groups of rhabdomyolysis were 5% ,20.45% ,rate of compartment syndrome were 0% ,4.55% ,the average hospital stay was 4.78 days ,6.89 . Conclusion The use of mannitol can reduce the CK value ,its use can significantly reduce the rhabdomyolysis and osteofascial compartment syndrome incidence ,and decrease the average hospitalization days ,the use of mannitol on CK intervention is re-duced and effective measures to prevent the occurrence of blood circulation in snakebite rhabdomyolysis and osteo-fascial compartment syndrome ,for no obvious blood circulation poison of snakebite contraindications mannitol can be used routinely in patients .