| Objective:To explore the effectiveness and timeliness of incision irrigation and negative pressure suction in the rabbit model of Chinese cobra bite poisoning.Methods:Previous studies have confirmed that the rabbit model of Chinese cobra bite poisoning can be successfully established by using0.466mg/kg venom powder and 8.0μl/kg water mixture.Using this model,we study the application effect of three methods,namely:incision irrigation,incision negative pressure suction,minimally invasive negative pressure suction.312 New Zealand white rabbits were randomly divided into 26 groups with 12rabbits in each group.One group was the experimental control group,which was not intervened after venom injection;one group was the blank control group,which was injected with normal saline;and the remaining 24 groups were divided into 8 groups with each method.Groups 1-4 of each method were injected with Chinese cobra venom solution to establish the rabbit model of Chinese cobra bite poisoning,namely 5-minute group,15-minute group,30-minute group and 60-minute group,one of the intervention methods was performed after 5 minutes,15 minutes,30 minutes and 60 minutes,respectively,and the liquid produced by injecting wound(washing fluid/negative pressure suction fluid)was collected in sterile syringes during the intervention process.The other 5-8 groups were the corresponding subgroups of each intervention group,namely 5-minute subgroup,15-minute subgroup,30-minute subgroup,and 60-minute subgroup,which would be injected with the collected corres-ponding washing fluid/negative pressure suction fluid respectively.Finally,the blood biochemical changes in 24 hours,the mortality and local necrotic area in each group after 72 hours were compared.Result:1.There was no significant difference in mortality among 5-minute group,15-minute group,30-minute group,60-minute group and experimental control group in each intervention method(P>0.05 for each).2.Comparison of necrotic area in Chinese cobra venom injection group:1)Incision negative pressure suction method:20.91±3.47cm~2 in 5-minute group,20.66±6.83cm~2 in 15-minute group,21.28±5.67cm~2 in 30-minute group and21.58±6.63cm~2in 60-minute group;Minimally invasive negative pressure suction method:20.74±6.87cm~2in 5-minute,23.42±6.29cm~2 in 15-minute,21.45±5.93 cm~2 in 30-minute and 22.71±6.38cm~2 in 60-minute;Both were larger than the experimental control group by 12.36±3.84cm~2,and the differences were statistically significant(P<0.05 for each).2)in every same time group,the pairwise comparison of the three methods showed that the necrotic area of incision negative pressure suction and minimally invasive negative pressure suction was larger than that of incision irrigation(P<0.05 for each),but there was no significant difference between the two methods(P>0.05).3)There was no significant difference in necrotic area among 5-minute group,15-minute group,30-minute group,60-minute group and experimental control group in the incision irrigation method(P>0.05).3.Corresponding subgroup necrotic area:pairwise comparison of three intervention methods:1)5-minute subgroup:incision negative pressure suction1.625±0.911cm~2,larger than minimally invasive negative pressure suction 0.807±0.415cm~2 and incision irrigation 0.083±0.058cm~2.2)15-minute subgroup:incision negative pressure suction 1.745±0.855cm~2,larger than minimally invasive negative pressure suction 0.833±0.484cm~2,larger than incision irrigation 0.080±0.068cm~2.3)30-minute subgroup:incision negative pressure suction1.47±0.646cm~2,larger than minimally invasive negative pressure suction0.817±0.495cm~2,and larger than incision irrigation 0.082±0.051cm~2.4)60-minute subgroup:incision negative pressure suction 1.612±0.998cm~2,greater than minimally invasive negative pressure suction 0.843±0.306cm~2,greater than incision irrigation 0.077±0.064cm~2,the difference was statistically significant(P<0.05 for each).5)In the same method,there was no significant difference in necrotic area among 5-minute subgroup,15-minute subgroup,30-minute subgroup and 60-minute subgroup(P>0.05 for each).4.Blood biochemical aspect:1)Creatine kinase isoenzyme MB was 1041±450 U/L in 5-minute group and 1272±774 U/L in 15-minute group in incision negative pressure suction method;In the minimally invasive negative pressure suction method,1169±591 U/L in 5-minute group and 1245±951 U/L in 15-minute group;They were all lower than the experimental control group 4473±2821 U/L(P<0.05 for each).2)Creatinine was 54.80±9.60μmol/L in 5-minute group and 55.60±6.91μmol/L in 15-minute group in incision negative pressure suction method;In the minimally invasive negative pressure suction method,58.67±6.38μmol/L in 5-minute group and 57.5±7.42μmol/L in 15-minute group;They were all lower than the experimental control group 73.33±14.04μmol/l(P<0.05 for each).3)Creatine kinase was significantly decreased in the5-minute group 39686±20332U/L,the 15-minute group 36420±14776U/L,the30-minute group 42365±8945U/L,and the 60-minute group 43101±17169U/L in incision negative pressure suction method;In the minimally invasive negative pressure suction method,the 5-minute group was 33367±13776U/L,the15-minute group was 34766±15405U/L,the 30-minute group was35698±20166U/L,and the 60-minute group was 41622±15242U/L,which were all higher than the experimental control group14072±5547U/L,the differences were statistically significant(P<0.05 for each).In the incision irrigation method,the 5-minute subgroup was 1075.1±2143.7U/L,the 15-minute subgroup was 1046.7±224.0U/L,the 30-minute subgroup was 1006.8±224.1U/L,and the60-minute subgroup was 1022.3±237.0 U/L;In the incision negative pressure suction method,the 5-minute subgroup was 1985±540 U/L,the 15-minute subgroup was 2746±1067 U/L,the 30-minute subgroup was 1667±793 U/L,and the 60-minute subgroup was 1842±1175 U/L;In the minimally invasive negative pressure suction method,the 5-minute subgroup was 2125±1022 U/L,the15-minute subgroup was 2401±801 U/L,the 30-minute subgroup was2333±1112 U/L,and the 60-minute subgroup was 2235±1337 U/L;all of which were greater than the blank control 706.3±173.2U/L;the differences were all statistically significant(P<0.05 for each).5.In the 4 time groups and 4 time subgroups of the three intervention methods,the pathological examination of the local injection site of the rabbits showed cell necrosis,while the blank control group did not show cell necrosis.Conclusion:1.Three kinds of methods such as incision irrigation,incision negative pressure suction and minimally invasive negative pressure suction can remove part of the venom poisoned by Chinese cobra bite,among which the amount of venom removed by incision negative pressure suction is the most,but the three methods have no effect on mortality.2.Incision/minimally invasive negative pressure suction can improve the damage of myocardial and renal function caused by Chinese cobra bite poisoning,but increase the necrotic area of local muscle and soft tissue to a certain extent.3.Negative pressure suction within 15 minutes of Chinese cobra bite poisoning is helpful to improve the function of myocardium and kidney. |
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