思维导图在毒蛇咬伤患者规范化治疗中的应用

刘小媛; 刘皖娟

doi:10.16766/j.cnki.issn.1674-4152.003006

思维导图在毒蛇咬伤患者规范化治疗中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003006

刘小媛^,,
刘皖娟

丽水市中心医院急诊监护室，浙江丽水 323000

基金项目:

浙江省卫生健康科技计划项目 2021ZH016

详细信息

通讯作者:
刘小媛，E-mail：41052469@qq.com

中图分类号: R595.8 R996.3
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出版历程
- 收稿日期: 2022-12-02

The Use of Mind Mapping in Standardized Treatment for Venomous Snake Bites

LIU Xiaoyuan^,,
LIU Wanjuan

Emergency Intensive Care Unit, Lishui Municipal Central Hospital, Lishui, Zhejiang 323000, China

摘要

摘要: 目的探讨思维导图对毒蛇咬伤患者救治效果、心理及生活质量的影响，为毒蛇咬伤规范化治疗提供理论依据。方法选取丽水市中心医院2020年2月—2022年5月收治的毒蛇咬伤患者68例，均采用抗蛇毒血清治疗，按照随机数字法分为对照组(34例，采用常规治疗)与试验组(34例，联合思维导图干预)。比较2组救治效果(肿胀消退时间、疼痛缓解时间、蛇伤创口愈合时间、住院时间、抢救成功率、救治满意率)、心理应激指标[90项症状自评量表(SCL-90)]、生活质量[生活质量综合评定调查问卷(GQOLI-74)]的变化。结果干预后，与对照组比较，试验组肿胀消退、疼痛缓解、蛇伤创口愈合及住院时间更短[(5.32±1.09)d vs. (6.84±1.22)d, (3.57±0.92) d vs. (4.73±1.03) d, (16.02±2.11)d vs. (20.91±2.35) d, (7.25±1.09) d vs. (10.16±1.85)，均P＜0.05]；试验组救治满意度为97.06%(33/34)，高于对照组的76.47%(26/34), P＜0.05。试验组躯体化、强迫症状、抑郁、焦虑、恐怖因子及总分低于对照组(均P＜0.05)；试验组躯体功能、心理功能、社会功能评分高于对照组(均P＜0.05)。试验组不良反应发生率为14.71%(5/34)，低于对照组的38.24%(13/34), P＜0.05。结论思维导图可提高毒蛇咬伤患者的救治效果，减轻患者的心理应激反应，提高患者的生活质量。
- 思维导图 /
- 毒蛇咬伤 /
- 规范化治疗 /
- 生活质量
Abstract: Objective To investigate the impact of mind mapping on the treatment effect, psychological status and quality of life in patients with venomous snake bites, and to provide a theoretical basis for standardized treatment of venomous snakebite patients. Methods Sixty-eight patients with venomous snake bites admitted to Lishui Municipal Central Hospital from February 2020 to May 2022, all treated with antivenom. They were selected and divided into a control group (34 cases, treated with conventional therapy) and a test group (34 cases, receiving the conventional therapy combined with mind mapping-based interventions) according to the random number table method. Clinical treatment effect (swelling regression time, pain relief time, snakebite wound healing time, hospitalization time, resuscitation success rate and satisfaction rate), psychological stress indicators [symptom checklist-90 (SCL-90)] and quality of life [general quality of life inventory-74 (GQOLI-74)] were compared between the two groups. Results After the intervention, the test group required less time to achieve swelling reduction, pain relief, snakebite wound healing and had shorter length of hospitalization time after intervention, compared with the control group, with statistically significant differences [(5.32±1.09) d vs. (6.84±1.22) d, (3.57±0.92) d vs. (4.73±1.03) d, (16.02±2.11) d vs. (20.91±2.35) d, (7.25±1.09) d vs. (10.16±1.85) d, all P < 0.05]. Moreover, the test group had a higher treatment satisfaction rate (97.06%, 33/34) compared with 76.47% (26/34) in the control group (P < 0.05). The test group had significantly lower average factor scores for somatization, obsessive-compulsive, depression, anxiety, phobic-anxiety and total SCL-90 after treatment (all P < 0.05). In addition, the average post-treatment scores of physical function, psychological function and social function were higher in the test group (all P < 0.05). The incidence of adverse reactions was lower in the test group (14.71%, 5/34) than that in the control group (38.24%, 13/34), P < 0.05. Conclusion Mind mapping-based interventions may help to improve the treatment effect, reduce the psychological stress response and improve the quality of life in patients with venomous snakebites.
- Mind mapping /
- Venomous snakebites /
- Standardized treatment /
- Quality of life
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图 1 毒蛇咬伤规范化急救处理方案

Figure 1. Standardized first aid treatment plan for snake bite

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图 2 毒蛇咬伤随访管理

Figure 2. Follow-up management of snake bite

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表 1 2组毒蛇咬伤患者一般资料比较

Table 1. Comparison of general data of two groups of patients bitten by venomous snakes

组别	例数	性别(例)		年龄(x±s，岁)	BMI(x±s)	咬伤部位(例)
组别	例数	男性	女性	年龄(x±s，岁)	BMI(x±s)	足背或足趾	小腿	手指或手掌	其他
对照组	34	20	14	34.50±4.41	22.53±2.21	14	13	3	4
试验组	34	18	16	35.68±4.27	22.27±2.43	15	11	5	3
统计值		0.239^a		-1.121^b	0.462^b	0.844^a
P值		0.625		0.133	0.323	0.839
注：^a为χ²值，^b为t值。

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表 2 2组毒蛇咬伤患者临床救治效果比较(x±s, d)

Table 2. Comparison of clinical treatment effects between the two groups of patients bitten by venomous snakes(x±s, d)

组别	例数	肿胀消退时间	疼痛缓解时间	创口愈合时间	住院时间
对照组	34	6.84±1.22	4.73±1.03	20.91±2.35	10.16±1.85
试验组	34	5.32±1.09	3.57±0.92	16.02±2.11	7.25±1.09
t值		5.418	4.898	9.028	7.902
P值		＜0.001	＜0.001	＜0.001	＜0.001

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表 3 2组毒蛇咬伤患者不良反应比较[例(%)]

Table 3. Comparison of adverse reactions between the two groups of patients bitten by venomous snakes[cases (%)]

组别	例数	过敏反应	多器官功能障碍综合征	伤肢感染	发热	总不良反应
对照组	34	4(11.76)	2(5.88)	3(8.82)	4(11.76)	13(38.24)
试验组	34	1(2.94)	1(2.94)	1(2.94)	2(5.88)	5(14.71)
注：2组总不良反应发生率比较，χ²=4.836，P=0.028。

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