CAJ | 학술논문

目的研究竹叶青蛇咬伤后患者血液学指标的动态变化特征。方法收集2011-01～2013-12在广州医科大学附属第一医院急诊科确诊为竹叶青蛇咬伤的患者49例，按照咬伤后不同的时间段对PLT、PT、APTT、INR、Fg及D-二聚体6项血液学指标进行统计分析。结果竹叶青蛇咬伤后，6项血液学指标在24 h内均呈现不同程度的异常变化。 PLT和Fg随发病时间的延长呈进行性下降，分别在第4天和第3天达最低值。 PT、APTT、INR及D-二聚体在咬伤后的24 h内明显升高；PT和APTT均在第3天达最高值，而INR和D-二聚体升高较快，在第2天已达最高值。上述6个血液学指标基本在第7～9天恢复正常。结论竹叶青蛇咬伤能引起凝血功能异常，血液学指标随时间不同呈动态变化；了解该规律有助于评估竹叶青蛇咬伤的预后和指导其临床治疗。
목적연구죽협청사교상후환자혈액학지표적동태변화특정。방법수집2011-01～2013-12재엄주의과대학부속제일의원급진과학진위죽협청사교상적환자49례，안조교상후불동적시간단대PLT、PT、APTT、INR、Fg급D-이취체6항혈액학지표진행통계분석。결과죽협청사교상후，6항혈액학지표재24 h내균정현불동정도적이상변화。 PLT화Fg수발병시간적연장정진행성하강，분별재제4천화제3천체최저치。 PT、APTT、INR급D-이취체재교상후적24 h내명현승고；PT화APTT균재제3천체최고치，이INR화D-이취체승고교쾌，재제2천이체최고치。상술6개혈액학지표기본재제7～9천회복정상。결론죽협청사교상능인기응혈공능이상，혈액학지표수시간불동정동태변화；료해해규률유조우평고죽협청사교상적예후화지도기림상치료。
Objective To study the dynamic change of hematological indices in patients with trimeresurus stejnegeri snakebite.Methods From January 2011 to December 2013, 49 cases of patients with trimeresurus stejnegeri snakebite in the emergency department of a hospital were collected. Six hematological indices including PLT, PT, APTT, INR, Fg and D-II were statistically analyzed during different time period post snakebite. Results In 24 hours post trimeresurus stejnegeri snakebite, the six hematological indices respectively showed different levels of abnormal changes.PLT and Fg decreased progressively after snakebite;PLT and Fg reached the lowest level respectively on 4th day and 3rd day.PT, APTT, INR and D-II increased in 24 hours; PT and APTT both reached the highest level, while INR and D-II showed faster growth comparatively by reaching the highest level on 2nd day.The above 6 hematological indices returned to normal levels after 7~9 days.Conclusion Trimeresurus stejnegeri snakebite can result in abnormal blood coagulation, and hematological indices change with time.Understanding of such pattern would be helpful for prognosis evaluation and clinical treatment of trimeresurus stejnegeri snake bite.