小切口负压治疗对毒蛇咬伤后肢体肿胀及炎症反应的影响

曾凡杰; 陈聪; 张雷; 陈翔宇; 周小萍; 刘明华

doi:10.16016/j.1000-5404.201609052

您当前的位置：

首页 >

文章列表页 >

小切口负压治疗对毒蛇咬伤后肢体肿胀及炎症反应的影响

基础医学 | 更新时间：2026-01-09

- 小切口负压治疗对毒蛇咬伤后肢体肿胀及炎症反应的影响
- Effects of small incisions and negative pressure wound therapy on limb swelling and inflammatory response induced by snakebite
- 第三军医大学学报 2017年39卷第3期页码：271-275
- 作者机构：
- 作者简介：
- 基金信息：
  
  重庆市科技惠民计划项目(CSTC2013jcsfc10001-4);第三军医大学临床创新基金(SWH2013LC11)
- DOI：10.16016/j.1000-5404.201609052
  中图分类号：
- 收稿：2016-09-07，
  
  纸质出版：2017-01-15
- 稿件说明：
移动端阅览
曾凡杰, 陈聪, 张雷, 等. 小切口负压治疗对毒蛇咬伤后肢体肿胀及炎症反应的影响[J]. 第三军医大学学报, 2017,39(3):271-275.

Fanjie Zeng, Cong Chen, Lei Zhang, et al. Effects of small incisions and negative pressure wound therapy on limb swelling and inflammatory response induced by snakebite[J]. Journal of Third Military Medical University, 2017, 39(3): 271-275.
曾凡杰, 陈聪, 张雷, 等. 小切口负压治疗对毒蛇咬伤后肢体肿胀及炎症反应的影响[J]. 第三军医大学学报, 2017,39(3):271-275. DOI： 10.16016/j.1000-5404.201609052.

Fanjie Zeng, Cong Chen, Lei Zhang, et al. Effects of small incisions and negative pressure wound therapy on limb swelling and inflammatory response induced by snakebite[J]. Journal of Third Military Medical University, 2017, 39(3): 271-275. DOI： 10.16016/j.1000-5404.201609052.

摘要

Abstract

Objective

To determine the effect of small incisions combined with negative pressure wound therapy on the healing of limb swelling and inflammatory response induced by snakebite.

Methods

Twenty-nine patients diagnosed as snakebite admitted in our emergency department from April 2015 to July 2016 were enrolled in this study. They were 18 males and 11 females

at an age of 18~65. The patients were randomly divided into control group and observation group. The patients of control group received the conventional comprehensive treatment. And those of the observation group were given with the negative pressure suction after a surgery in proximal limb skin by multiple small incisions

and the conventional comprehensive treatment at the same time. At the initial time of treatment

and in 6

48 and 72 h during treatment

the perimeters of injured limb on the proximal

middle and distal sites

and the corresponding sites of the unaffected limb were measured and recorded to calculate the difference values. At the time points

the plasma contents of IL-6 and TNF-α were detected. The above results

and the length of hospital stay were compared between the 2 groups. This study was registered and approved by the Chinese Clinical Trail Registration and Ethnic Review Commission (registration number: ChiCTR-TRC-14004189).

Results

Significance differences were found in the differences of the perimeters of injured limb to the unaffected limb between the observation group to the control group

with the former obviously lower than the latter group at all the time points (

0.05). The plasma contents of IL-6 and TNF-α were remarkably lower in the observation group than the control group at all time points after treatment (

0.05). Significant difference was also found in the average length of hospital stay between the 2 groups

with the observation group shorter (5.43±1.07

7.67±1.95 d

=0.001).

Conclusion

Small incisions combined with negative pressure wound therapy on the basis of conventional comprehensive treatment can effectively control the limb swelling

reduce the systemic inflammatory responses

and shorten the length of hospital stay.

关键词

Keywords

references

Warrell D A WHO/SEARO Guidelines for the clinical management of snake bites in the Southeast Asian region Southeast Asian J Trop Med Public Health 1999 30 Suppl 1 1 85 https://www.ncbi.nlm.nih.gov/pubmed/10983553 Warrell D A.WHO/SEARO Guidelines for the clinical management of snake bites in the Southeast Asian region[J]. Southeast Asian J Trop Med Public Health, 1999, 30 (Suppl 1): 1-85.

Gutiérrez J M León G Burnouf T Antivenoms for the treatment of snakebite envenomings: the road ahead Biologicals 2011 39 3 129 142 10.1016/j.biologicals.2011.02.005 Gutiérrez J M, León G, Burnouf T. Antivenoms for the treatment of snakebite envenomings: the road ahead[J]. Biologicals, 2011, 39(3): 129-142. DOI: 10.1016/ j.biologicals.2011.02.005

Gay C C Maruñak S L Teibler P Systemic alterations induced by a Bothrops alternatus hemorrhagic metalloproteinase (baltergin) in mice Toxicon 2009 53 1 53 59 10.1016/j.toxicon.2008.10.010 Gay C C, Maruñak S L, Teibler P, et al. Systemic alterations induced by a Bothrops alternatus hemorrhagic metalloproteinase (baltergin) in mice[J]. Toxicon, 2009, 53(1): 53-59. DOI: 10.1016/j.toxicon. 2008.10.010

Karabuva S Vrkiç I Briziç I Venomous snakebites in children in southern Croatia Toxicon 2016 112 8 15 10.1016/j.toxicon.2016.01.057 Karabuva S, VrkiçI, BriziçI, et al. Venomous snakebites in children in southern Croatia[J]. Toxicon, 2016, 112: 8-15. DOI: 10.1016/j.toxicon.2016.01.057

Daeschlein G Napp M Lutze S Comparison of the effect of negative pressure wound therapy with and without installation of polyhexanide on the bacterial kinetic in chronic wounds Wound Medicine 2016 13 5 11 10.1016/j.wndm.2016.02.001 Daeschlein G, Napp M, Lutze S, et al. Comparison of the effect of negative pressure wound therapy with and without installation of polyhexanide on the bacterial kinetic in chronic wounds[J]. Wound Medicine, 2016, 13: 5-11.DOI: 10.1016/j.wndm.2016.02.001

章均王珊李长春 Downey分级在儿童毒蛇咬伤诊治中的应用中华实用儿科临床杂志 2013 28 20 1592 1595 10.3969/cma.j.issn.2095-428X.2013.20.021 章均, 王珊, 李长春, 等. Downey分级在儿童毒蛇咬伤诊治中的应用[J].中华实用儿科临床杂志, 2013, 28(20): 1592-1595.DOI:10.3969/cma.j.issn.2095-428X.2013.20.021

Downey D J Omer G E Moneim M S New Mexico rattlesnake bites: demographic review and guidelines for treatment J Trauma 1991 31 10 1380 1386 10.1097/00005373-199110000-00011 Downey D J, Omer G E, Moneim M S. New Mexico rattlesnake bites: demographic review and guidelines for treatment[J]. J Trauma, 1991, 31(10): 1380-1386.

Lavonas E J Kokko J Schaeffer T H Short-term outcomes after Fab antivenom therapy for severe crotaline snakebite Ann Emerg Med 2011 57 2 128 137 10.1016/j.annemergmed.2010.06.550 Lavonas E J, Kokko J, Schaeffer T H, et al. Short-term outcomes after Fab antivenom therapy for severe crotaline snakebite[J]. Ann Emerg Med, 2011, 57(2): 128-137. DOI: 10.1016/j.annemergmed.2010.06.550

Gutiérrez J M Williams D Fan H W Snakebite envenoming from a global perspective: Towards an integrated approach Toxicon 2010 56 7 1223 1235 10.1016/j.toxicon.2009.11.020 Gutiérrez J M, Williams D, Fan H W, et al. Snakebite envenoming from a global perspective: Towards an integrated approach[J]. Toxicon, 2010, 56(7): 1223-1235. DOI: 10.1016/j.toxicon.2009.11.020

Paniagua D Jiménez L Romero C Lymphatic route of transport and pharmacokinetics of Micrurus fulvius (coral snake) venom in sheep Lymphology 2012 45 4 144 153 https://www.researchgate.net/publication/236934502_Lymphatic_route_of_transport_and_pharmacokinetics_of_Micrurus_fulvius_coral_snake_venom_in_sheep Paniagua D, Jiménez L, Romero C, et al. Lymphatic route of transport and pharmacokinetics of Micrurus fulvius (coral snake) venom in sheep[J]. Lymphology, 2012, 45(4): 144-153.

Salman A E Yetişir F Aksoy M Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen Hernia 2014 18 1 99 104 10.1007/s10029-012-1008-0 Salman A E, Yetişir F, Aksoy M, et al. Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen[J]. Hernia, 2014, 18(1): 99-104. DOI: 10.1007/s10029-012-1008-0

Açıkalın A Gökel Y Serum IL-6, TNFα levels in snakebite cases occurring in Southern Turkey Emerg Med J 2011 28 3 208 211 10.1136/emj.2009.078428 Açıkalın A, Gökel Y. Serum IL-6, TNFα levels in snakebite cases occurring in Southern Turkey[J]. Emerg Med J, 2011, 28(3): 208-211. DOI: 10.1136/emj.2009.078428

Guisasola M C Ortiz A Chana F Early inflammatory response in polytraumatized patients: Cytokines and heat shock proteins. A pilot study Orthop Traumatol Surg Res 2015 101 5 607 611 10.1016/j.otsr.2015.03.014 Guisasola M C, Ortiz A, Chana F, et al. Early inflammatory response in polytraumatized patients: Cytokines and heat shock proteins. A pilot study[J]. Orthop Traumatol Surg Res, 2015, 101(5): 607-611. DOI: 10.1016/j.otsr.2015.03.014

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

暂无数据