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蛇咬伤患者发生横纹肌溶解的临床特征及相关危险因素分析
Authors Wang FZ, Xiang SH, Lin SQ, Qian FQ, Zhang QX, Geng MH, Deng JX, Wu SC
Received 27 August 2024
Accepted for publication 8 November 2024
Published 26 November 2024 Volume 2024:17 Pages 5535—5546
DOI https://doi.org/10.2147/IJGM.S479291
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Woon-Man Kung
Fu-zhen Wang,1,* Shi-hong Xiang,1,2,* Sen-qing Lin,1 Feng-qi Qian,1 Qiu-xia Zhang,1 Ming-hui Geng,1 Jin-xiu Deng,1 Sen-chao Wu1
1Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, Fujian 364000, People’s Republic of China; 2Department of Nephrology, Xuanhan County People’s Hospital, Dazhou, Sichuan, 636150, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Sen-chao Wu; Jin-xiu Deng, Department of Nephrology, Longyan First Affiliated Hospital of Fujian Medical University, No.105 Jiuyi North Road, Longyan, Fujian, 364000, People’s Republic of China, Tel +86 13860217030 ; Tel +86 18159828598, Email wusenchaowsc@126.com; dengjinxiudjx@126.com
Objective: To enhance the understanding of rhabdomyolysis (RM) caused by snakebites and to promptly identify and intervene in the risk factors associated with RM.
Methods: A retrospective analysis involving 209 snakebite victims who visited our hospital for snakebite cases was conducted. Among these, 43 were related to RM, while 166 did not exhibit RM (NRM). The clinical characteristics, treatment, and prognostic outcomes of both groups were statistically analyzed, with the aim of interpreting the risk factors associated with snakebites concurrent with RM through logistic regression analysis.
Results: Snakebite incidents commonly manifest during the summer and autumn seasons, predominantly affecting middle-aged and elderly populations, with injuries mostly occurring in the limbs. Creatine kinase (CK), CK isoenzyme MB, and lactate dehydrogenase indicators exhibited significantly elevated levels in the RM group compared to the NRM group (P < 0.05). Moreover, the RM Group displayed heightened susceptibility to complications such as osteofascial compartment syndrome, multiple organ dysfunction (MODS), acute kidney injury, etc. (P < 0.05). Debridement and blood purification procedures were more frequently administered to the RM group in comparison to the NRM group (P < 0.05). Notably, visitation beyond 6 hours post-bite and hemoglobin levels below 90 mg/dl emerged as independent risk factors for those with RM following snakebites, while female gender and albumin levels > 40 g/L were identified as protective factors against such occurrences.
Conclusion: Snakebite victims with RM have more severe clinical conditions, necessitating prolonged treatment duration, and exhibit heightened mortality rates in comparison to those without RM.
Keywords: acute kidney injury, clinical features, rhabdomyolysis, risk factors, snakebite