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目的探讨五步蛇咬伤患者在不同时间段出凝血功能的改变和临床意义。方法对本院136例五步蛇咬伤患者未治疗前采集血标本,检测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原含量(FIB)、D-二聚体(D-Dimer)及血小板计数(PLT)。按照咬伤后就诊不同时间段分为蛇伤A组、蛇伤B组和蛇伤C组,与对照组进行比较分析。结果五步蛇咬伤患者D-Dimer、PT、APTT、TT显著高于对照组,PLT、FIB显著低于对照组,差异有统计学意义(P<0.01);蛇伤A组PLT、FIB检测结果显著低于对照组,差异有统计学意义(P<0.01),而D-Dimer、PT、APTT、TT与对照组相比,差异无统计学意义(P>0.05);蛇伤B组、蛇伤C组分别与对照组、蛇伤A组相比,PT、APTT、TT、D-Dimer显著升高,FIB、PLT显著降低,差异有统计学意义(P<0.01)。结论蛇咬伤患者在不同时间段呈现出不同的凝血功能状态,临床上应对五步蛇咬伤患者进行动态全面的凝血功能检测。
Objective To investigate the changes and clinical significance of coagulation function in patients with five-step snake bite at different time points. Methods Blood samples were collected before treatment in 136 patients with five-step snake bites in our hospital. Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen content (FIB), D-dimer and platelet count (PLT). According to different time periods after the bite treatment, the rats were divided into group A with snakebite, group B with snakebite and group C with snakebite, which were compared with the control group. Results The levels of D-Dimer, PT, APTT and TT in the five-step snake bite patients were significantly higher than those in the control group, and the PLT and FIB were significantly lower than those in the control group (P <0.01) The results were significantly lower than those in the control group (P <0.01), but there was no significant difference between D-Dimer, PT, APTT and TT groups (P> 0.05) The levels of PT, APTT, TT and D-Dimer in group C were significantly higher than those in control group and snakebite group, respectively. The FIB and PLT in group C were significantly lower than those in control group and snakebite group (P <0.01). Conclusion The snakebite patients showed different coagulation status at different time points, and the dynamic and comprehensive coagulation tests should be performed clinically in patients with five-step snake bites.