张家界地区毒蛇咬伤的流行病学研究

Epidemiological Study on Venomous Snake Bites in Zhangjiajie Area

摘要: 目的：分析湖南省张家界地区毒蛇咬伤的流行病学特征，为毒蛇咬伤的防治提供依据。方法：采用回顾性分析法收集张家界地区2023年1月至2014年12月201例毒蛇咬伤患者的临床资料，分析致伤蛇种、患者的性别、年龄、民族、职业、受伤原因、受伤月份、就诊时间、院前处理、严重程度、住院天数等资料。结果：张家界地区毒蛇咬伤的主要致伤蛇种为蝮蛇(63.18%)、五步蛇(17.91%)、不明种类(15.42%)、烙铁头(2.49%)、银环蛇(1.00%)；患者多为中老年男性农民；毒蛇咬伤好发季节为夏秋季；大部分患者在3 h内来院就诊；院前处理中捆扎(50.75%)使用最普遍，但仍有23.88%未采取任何措施；受伤部位大部分为上肢；毒蛇咬伤以轻度为主，平均住院天数为5.2天。结论：湖南张家界地区的毒蛇咬伤以蝮蛇居多，大多发生于夏秋季，以中老年男性农民居多，就诊时间在3 h内，院前处理不足，需加强高危人群的防护教育、优化急救措施，并建立区域性蛇伤救治体系。

Abstract: Objective: To analyze the epidemiological characteristics of snake bites in Zhangjiajie, Hunan Province, and to provide evidence for the prevention and treatment of snake bites. Methods: The clinical data of 201 patients with snakebite in Zhangjiajie from January 2023 to December 2014 were retrospectively collected. The species of snake, gender, age, ethnicity, occupation, cause of injury, injury month, treatment time, pre-hospital treatment, severity and length of hospital stay were analyzed. Results: The main venomous snake bites in Zhangjiajie area were Agkistrodon halys bite (63.18%), Agkistrodon ocutus (17.91%), unknown species (15.42%), soldering iron (2.49%), and Garnoclast (1.00%). Most of the patients were middle-aged and elderly male farmers. Venomous snake bites usually occur in summer and autumn. Most patients came to the hospital within 3 hours. Strapping (50.75%) was the most commonly used pre-hospital treatment, but 23.88% of them did not take any measures. Most of the injured parts were upper limbs. The majority of venomous snake bites were mild, and the average length of hospital stay was 5.2 days. Conclusions: Agkistrodon halys bite is the most common snakebite in Zhangjiajie, Hunan Province. Most of the snakebites occur in summer and autumn, and most of them are middle-aged and elderly male farmers. The treatment time is less than 3 hours, and pre-hospital treatment is insufficient.