摘要
目的:分析湖北地区蝮蛇咬伤成人患者的临床特征与长期住院相关因素,建立预测模型,为蛇咬伤的诊治提供临床参考。方法:回顾性分析2018年4月—2023年6月武汉大学人民医院急诊科接诊并收治入院的32例蝮蛇咬伤成人患者的临床资料,评估基线水平,依据患者住院时长分为短期住院组(17例)和长期住院组(15例),进行组间单因素分析与多因素逻辑回归,建立Nomogram模型,并用ROC曲线完善数据验证等。结果:长期住院组患者在入院收缩压、红细胞计数、白细胞计数、中性粒细胞计数、丙氨酸氨基转移酶水平与活化部分凝血酶原时间等入院基线水平均高于短期住院组,差异有统计学意义(P<0.05),多因素分析则揭示了其中丙氨酸氨基转移酶为患者长期住院的独立危险因素。结论:蝮蛇咬伤对成人患者的炎症水平、肝功能、凝血功能造成的影响与长期住院时长的概率增加正相关,其中丙氨酸氨基转移酶的指示性尤为突出。
Objective:To analyze the clinical characteristics of adult patients bitten by vipers in the Hubei area and the factors related to long-term hospitalization,establish a predictive model,and provide clinical reference for the diagnosis and treatment of snakebite injuries.Methods:A retrospective analysis of the clinical data of 32 adult patients bitten by vipers,who were admitted to our hospital's emergency department from April 2018 to June 2023,was conducted to assess baseline levels.Based on the length of hospital stay,patients were divided into a short-term hospitalization group(17 cases)and a long-term hospitalization group(15 cases).Univariate analysis and multivariate logistic regression were performed between groups to establish a Nomogram model,and data validation was refined with ROC curves,among other methods.Results:Patients in the long-term hospitalization group had higher baseline levels upon admission,including systolic blood pressure,red blood cell count,white blood cell count,neutrophil count,levels of alanine aminotransferase,and activated partial thromboplastin time,compared to the short-term hospitalization group(P<0.05).Multivariate analysis revealed that alanine aminotransferase level is an independent risk factor for long-term hospitalization in patients.Conclusion:The impact of viper bites on the levels of inflammation,liver function,and coagulation function in adult patients is positively correlated with the increased probability of a prolonged hospital stay,with the indication of alanine aminotransferase being particularly prominent.
作者
马承泰
吴淼
白镓玮
严颜
解鑫宇
杜贤进
MA Chengtai;WU Miao;BAI Jiawei;YAN Yan;XIE-Xinyu;DU Xianjin(Department of Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan,430060,China;Department of Emergency,Renmin Hospital of Wuhan University)
出处
《临床急诊杂志》
CAS
2024年第3期129-133,共5页
Journal of Clinical Emergency
关键词
蛇咬伤
蝮蛇
预后
预测模型
snakebite
pit viper
prognosis
predictive model
