中文摘要：

目的：探讨蝮蛇咬伤后患者就诊时间与心肌酶谱及伤肢肿胀的关系,以期指导临床治疗。方法：回顾性分析蝮蛇咬伤中毒患者140例的临床资料,根据就诊时间的不同分为三组,分别为：就诊时间≤12 h组（A组）,12 h〈就诊时间≤24 h组（B组）和就诊时间〉24 h组（C组）,并根据患者肢体肿胀程度分轻度、中度、重度肿胀三组。分组统计入院时间与心肌损害有关的心肌酶谱指标,并统计肢体肿胀与相关的心肌酶谱指标,进行临床关系分析。结果：入院时间与心肌酶谱升高相关,24 h以后心肌酶谱明显升高。蝮蛇咬伤肢体肿胀发展快,12 h以内已达到高峰。中、重度肿胀组与轻度肿胀组比较,心肌酶谱各项指标明显增高,比较差异均有统计学意义（P〈0.001）。结论：蝮蛇咬伤后肢体肿胀及心肌损害发展快,因此应尽快进行受伤肢体肿胀的治疗,并应尽早防治心肌损害。

英文摘要：

Objective：To explore the agkistrodon halys bite after the time of patients with myocardial enzyme spectrum and the relationship of the injured limb swelling,in order to guide clinical treatment.Method：The clinical data of 140 patients bitten by agkistrodon halys poisoning were retrospectively analyzed,according to the different treatment time,they were randomly divided into three groups respectively：time to 12 h or less group（group A）,12 h24 h group（group C）,and according to the limb swelling degree,the patients were divided into the mild swelling group,the moderate swelling group,the severe swelling group.To group and recorde admission time and myocardial damage related enzyme spectrum index,and observe the limb swelling and myocardial enzyme spectrum associated index,analyze the clinical relationship.Result：Admission time was associated with elevated myocardial enzymes,myocardial enzyme spectrum increased significantly after 24 hours a day.The agkistrodon halys bites limb swelling developed rapidly,had reached within 12 hours.Conclusion：The limb swelling and myocardial injury development fast after Agkistrodon halys bite,so as soon as possible for the treatment of injured limb swelling and should prevent myocardial damage as early as possible.