竹叶青蛇咬伤的流行病学调查及院前影响因素分析

黄培颖; 曾仲意; 刘强; 刘禹翔; 曾林生

doi:10.13201/j.issn.1009-5918.2020.05.012

竹叶青蛇咬伤的流行病学调查及院前影响因素分析

- 1. 广州中医药大学第四临床医学院(广东深圳, 518000);
- 2. 深圳市中医院急诊科
基金项目:
深圳市卫生计生系统科研项目(No:201803070537、SZFZ2018012)

详细信息

通讯作者: 曾仲意,E-mail:szszzy@qq.com

中图分类号: R646

收稿日期: 2020-03-03

Epidemiological investigation and analysis of influencing factors before hospital on the bite of trimeresurus stejnegeri

- 1.The Fourth Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Shenzhen, 518000, China;
- 2.Department of Emergency, Shenzhen Hospital of Traditional Chinese Medicine

More Information

Corresponding author: ZENG Zhongyi, E-mail: szszzy@qq.com

Received Date: 03 March 2020

摘要

摘要: 目的:研究竹叶青蛇咬伤的流行病学特征及首诊患者病情轻重程度的影响因素,为竹叶青蛇咬伤的预防及控制院前中毒进展提供依据。方法:回顾性地收集2012-12-01—2017-12-01期间就诊于深圳市中医院蛇伤中心的593例竹叶青蛇咬伤患者信息,分析其流行病学特征;同时以纳排标准从中筛选出460例患者,通过组间比较及二分类多元Logistic回归模型,分析竹叶青蛇咬伤患者首诊病情轻重程度的影响因素,并对构成影响的部分因素绘制ROC曲线,找出最佳cutoff值。结果:竹叶青蛇咬伤主要发生在夏秋两季,夜间多发,高发人群是中青年男性,高发地点是在户外;单因素分析结果显示受伤后到院时间的组间比较差异有统计学意义(P=0.003);多因素分析结果显示咬伤后到院的时间长短是患者首诊病情轻重程度的独立危险因素(OR=1.022,95%CI:1.011~1.032),患肢近端结扎是有利影响因素(OR=0.553,95%CI:0.311~0.985);ROC曲线显示咬伤后到院时间有预测价值(AUC=0.613),cutoff值为22 h。结论:深圳市及周边地区竹叶青蛇咬伤多发生在夏秋两季,夜间多发,高发人群是中青年男性,高发地点是户外;被竹叶青蛇咬伤后越久到专业医院采取有效治疗,其病情越严重,病情加重的时间窗为22 h;咬伤后院前予患肢近端结扎,能有效减轻到院病情严重程度,而院前进行伤口冲洗并没有对患者到院病情显示出有利作用。
- 竹叶青蛇咬伤 /
- 流行病学 /
- 危险因素 /
- 预防
Abstract: Objective: To study the epidemiological characteristics of Trimeresurus Stejnegeri bite and the influencing factors of severity of the patients who first visit the hospital after bitten by Trimeresurus Stejneger, to provide the basis for the prevention and control of pre-hospital poisoning. Method: All the patients bitten by Trimeresurus Stejnegeri and visit the hospital for treat from December 1, 2012 to December 1, 2017 were retrospectively collected and their epidemiological characteristics were analyzed. At the same time, 460 patients were screened out with the exclusion criteria, and the influencing factors of the severity of the patients who first visit the hospital after bitten by Trimeresurus Stejneger were analyzed through the binary multiple Logistic regression model, and the ROC curve was drawn for the influencing factors to find the best cutoff value. Result: Trimeresurus Stejnegeri bites mainly occur in summer and autumn. It occurs frequently at night. The high incidence population is young and middle-aged men, and the high incidence place is outdoors. The results of univariate analysis showed that there was significant difference between the groups in the length of time to hospital after the bite(P=0.003). The results of multivariate analysis showed that the length of time to hospital after the bite was an independent risk factor(OR=1.022, 95%CI:1.011-1.032), and proximal limb ligation was a favorable factor(or=0.553, 95%CI :0.311-0.985); ROC curve showed that there is a predictive value(AUC=0.613) for the time to hospital after the bite, and the cutoff value was 22 h.Conclusion: In Shenzhen and its surrounding areas, most of the bruising occurred in summer and autumn, and at night. The high-risk population was young and middle-aged men, and the high-risk place was outdoors. The longer the bruising was treated in a professional hospital, the more serious the disease was, and the time window of aggravation was about 22 hours. It can effectively reduce the severity of the disease by ligating the proximal part of the affected limb before arriving at the hospital, while the wound washing before the hospital does not show a beneficial effect.
- trimeresurus stejnegeri bite /
- epidemiology /
- risk factors /
- prevention

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