遭受蛇咬患者的凝血功能障碍。
Coagulopathy in patients who experience snakebite.
作者信息
Kim Jae Seok, Yang Jae Won, Kim Min Soo, Han Seung Tae, Kim Bi Ro, Shin Myung Sang, Lee Jong In, Han Byoung Geun, Choi Seung Ok
机构信息
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
出版信息
Korean J Intern Med. 2008 Jun;23(2):94-9. doi: 10.3904/kjim.2008.23.2.94.
BACKGROUND/AIMS: Coagulopathy is a common complication of snakebite, but there is little information on the clinical importance of coagulopathy. We analyzed the characteristics of coagulopathy after envenomation.
METHODS
Ninety-eight patients who experienced snakebite were enrolled in this study. We divided all the patients into three groups by the ISTH DIC scoring system: the normal, simple coagulopathy and DIC groups. The coagulopathy group included both the simple coagulopathy and DIC groups. We then conducted a case-control study.
RESULTS
There was a significant decrease in the Hct, protein, albumin, ALP and cholesterol levels in the coagulopathy group, and only the cholesterol level was deceased in the DIC group (0<0.05). Leukocytosis and rhabdomyolysis were significantly associated with coagulopathy, and hemolysis and rhabdomyolysis were associated with DIC (p<0.05). The presence of rhabdomyolysis was considered a risk factor for coagulopathy (p<0.05). These conditions continued for up to six to seven days after the snakebite.
CONCLUSIONS
Evaluation of coagulopathy with using these characteristics is helpful to properly manage the patients who experience snakebite.
背景/目的：凝血病是蛇咬伤的常见并发症，但关于凝血病临床重要性的信息较少。我们分析了蛇毒中毒后凝血病的特征。
方法
本研究纳入了98例蛇咬伤患者。我们根据国际血栓与止血学会（ISTH）弥散性血管内凝血（DIC）评分系统将所有患者分为三组：正常组、单纯凝血病组和DIC组。凝血病组包括单纯凝血病组和DIC组。然后我们进行了一项病例对照研究。
结果
凝血病组的血细胞比容、蛋白质、白蛋白、碱性磷酸酶（ALP）和胆固醇水平显著降低，而DIC组仅胆固醇水平降低（P<0.05）。白细胞增多症和横纹肌溶解症与凝血病显著相关，溶血和横纹肌溶解症与DIC相关（P<0.05）。横纹肌溶解症的存在被认为是凝血病的一个危险因素（P<0.05）。这些情况在蛇咬伤后持续长达六至七天。
结论
利用这些特征评估凝血病有助于对蛇咬伤患者进行适当管理。
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