Epidemiological Characteristics of Venomous Snakebite in Yunnan Province
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摘要:
目的 探究2023－2024年云南省毒蛇咬伤的流行病学特点及治疗效果。 方法 收集云南省16个地级行政区2023年1月至2024年12月收治的 1727 例蛇伤病例资料，采用回顾性分析方法，重点考察以下指标：（1）人口学特征（年龄、性别分布）；（2）伤害事件特征（发生地点、时间分布、受伤部位）；（3）毒蛇种类构成；（4）临床特征与处置方案；（5）疗效评价指标（局部症状缓解时间、住院天数及随访结果）。结果 云南省蛇咬伤事件高发地区为文山（308/ 1727 ）、昆明（285/1727 ）、曲靖（270/1727 ）、临沧（139/1727 ）、保山（120/1727 ）、大理（105/1727 ）等，主要发生在6～9月份；最常见的毒蛇种类为以血液毒毒素为主的烙铁头蛇（Ovophis）和竹叶青蛇（Trimeresurus）；咬伤人群大部分为青年；临床表现主要为疼痛和肿胀；咬伤部位主要为四肢；咬伤地点主要为山林/山地；抗蛇毒血清使用以抗五步蛇蛇毒血清为主；肿胀消退时间大多为2（2，3）d，平均住院时长为4（3，5）d；96.46%接受正规诊疗的蛇伤患者基本痊愈，随访0.35%的致残率。结论 云南省毒蛇咬伤事件高发于文山、昆明、曲靖等地，夏季（6～9月）为高峰期，主要由烙铁头蛇和竹叶青蛇（血液毒）引发，青年群体四肢咬伤为主，表现为疼痛肿胀。治疗以抗五步蛇血清为主，患者平均住院4d，96.46%经正规诊疗后痊愈，致残率仅0.35%，目前仍需要提高公众对蛇咬伤规范诊疗的认识。 Abstract:Objective To explore the epidemiological characteristics and treatment outcomes of venomous snake bites in Yunnan Province from 2023 to 2024. Methods A retrospective analysis was performed on 1, 727 snakebite cases collected from 16 administrative regions in Yunnan Province between January 2023 and December 2024, focusing on the following indicators: （1） demographic characteristics （age and gender distribution）; （2） characteristics of injury events （location, time distribution, and affected body parts）; （3） composition of venomous snake species; （4） clinical features and treatment protocols; （5） efficacy evaluation indicators （time for local symptom relief, duration of hospital stay, and follow-up results）. Results High-incidence areas for snake bites in Yunnan Province included Wenshan （308/ 1727 ）, Kunming （285/1727 ）, Qujing （270/1727 ）, Lincang （139/1727 ）, Baoshan （120/1727 ）, and Dali （105/1727 ）, with incidents primarily occurring from June to September. The most frequently encountered venomous snake species were Ovophis and Trimeresurus, known for their hemotoxic venom. Bite victims were mainly young adults. Clinical manifestations primarily included pain and swelling, with bites mainly occurring on limbs and in mountainous or forested areas. Anti-venom treatment concentrated on anti-ancistrodon acutus serum. Swelling generally subsided within 2 （2, 3） days, with an average hospital stay of 4 （3, 5） days. 96.46% of patients receiving standardized treatment fully recovered, with a follow-up disability rate of 0.35%.Conclusion Snake bites in Yunnan Province are most common in Wenshan, Kunming, and Qujing, peaking during the summer months （June-September）. These incidents are primarily caused by Ovophis and Trimeresurus, which possess hemotoxic venom. Young adults often experience limb bites that are characterized by pain and swelling. Treatment mainly involves the use of anti-ancistrodon acutusserum, which has a recovery rate of 96.46% and a disability rate of only 0.35%. Additional efforts are necessary to enhance public awareness regarding standardized diagnosis and treatment of snake bites. -
Key words:
- Venomous snakebite /
- Epidemiology /
- Treatment
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图 1 2023-2024年云南省致伤毒蛇种类统计
Figure 1. Statistics on the types of venomous snakes that cause injuries in Yunnan Province from 2023 to 2024
图 2 2023-2024年云南省致伤毒蛇毒性效应种类统计
Figure 2. Statistical analysis of venomous snake species and their toxic effects in Yunnan Province from 2023 to 2024
图 3 2023-2024年云南省16个州市致伤毒蛇种类分类统计
Figure 3. Classification statistics of venomous snake species injuring in 16 cities and prefectures of Yunnan Province from 2023 to 2024
图 4 2023-2024年云南省16个州市致伤毒蛇毒性效应分类统计
Figure 4. Classification statistics of the toxic effects of venomous snakes in 16 prefectures and cities of Yunnan Province from 2023 to 2024
图 5 2023-2024年云南省16个州市致伤毒蛇季节分布统计
Figure 5. Seasonal Distribution statistics of venomous snakes causing injuries in 16 prefectures of Yunnan Province in 2023-2024
图 6 云南省2023年、2024年毒蛇致伤患者年龄分布统计
Figure 6. Age distribution statistics of snakebite patients in Yunnan Province form 2023 to 2024
图 7 2023-2024年云南省毒蛇致伤患者年龄分布统计
Figure 7. Age distribution statistics of snake bite victims in Yunnan Province from 2023 to 2024
图 8 2023、2024年云南省毒蛇致伤患者性别分布统计
Figure 8. Gender distribution statistics of snakebite patients in Yunnan Province from 2023 and 2024
图 9 2023-2024年云南省毒蛇致伤地点分布统计
Figure 9. Distribution venomous snake bite locations in Yunnan Province for 2023 to 2024
图 10 2023-2024年云南省毒蛇致伤部位统计
Figure 10. Statistics on the injury sites caused by venomous snakes in Yunnan Province for 2023 to 2024
图 11 2023-2024年云南省毒蛇致伤主要临床表现统计
Figure 11. Statistics of the main clinical manifestations of snakebite injuries in Yunnan Province from 2023 to 2024
图 12 2023-2024年云南省部分地州毒蛇致伤后首次就诊时间统计
Figure 12. Statistics of first medical visits after snake bites in some prefectures of Yunnan Province from 2023 to 2024
图 13 2023-2024年云南省四种单价抗蛇毒血清使用情况统计
Figure 13. Statistical analysis of the usage of four types of antivenom serum at unit prices in Yunnan Province for 2023 to 2024
图 14 肿胀消退时间中位数及四分位数统计
Figure 14. Median and quartile statistics of the swelling resolution time
图 15 毒蛇致伤住院时间分阶段统计
Figure 15. Phase-by-phase statistics of hospitalization time for snakebite victims
图 16 毒蛇致伤患者出院情况统计
Figure 16. Statistics on the discharge status of patients injured by venomous snakes
图 17 毒蛇致伤患者出院后随访情况统计
Figure 17. Statistical follow-up of patients discharged after venomous snake bites
表 1 2023年-2024年云南省16个州市蛇咬伤病例统计
Table 1. Statistics of snakebite cases in 16 prefectures of Yunnan Province from 2023 to 2024
地区 海拔（m） 病例（n） 性别（男/女） 昆明市 746～ 4344 285 151/134 曲靖市 695～ 4017 270 173/97 玉溪市 1500 ～1800 37 18/19 昭通市 267～ 4041 99 66/33 保山市 643～ 3655 120 43/77 丽江市 1015 ～5596 34 15/19 普洱市 317～ 3370 35 18/17 临沧市 450～ 3429 139 86/53 大理白族自治州 1340 ～4097 105 72/33 西双版纳傣族自治州 477～ 2429 63 32/31 迪庆藏族自治州 1486 ～6740 13 9/4 怒江傈僳族自治州 738～ 4000 21 12/9 文山壮族苗族自治州 400～ 2700 308 185/123 楚雄彝族自治州 691～ 2916 85 50/35 红河哈尼族彝族自治州 76～ 3074 79 46/33 德宏傣族景颇族自治州 210～ 3404 34 14/2 
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