Chippaux J P, Amadi-Eddine S, Fagot P
Médecin, directeur de recherche à l'IRD (ex-ORSTOM), Centre Pasteur du Cameroun, Yaoundé.
Bull Soc Pathol Exot. 1999 May;92(2):109-13.
A study on blood incoagulability due to snake bites was carried out in the Soudanian savanna of North Cameroon, in a provincial hospital receiving patients with severe envenoming coming from areas within 250 km of the hospital. Clinical and biological examinations were conducted on 57 voluntary patients to determine the aetiology of blood incoagulability. The aetiology of this syndrome is complex and seems to depend on the variability of venom components and/or the time between bite and hospital admission inducing a diversity of biological signs. Furthermore, the presence of bleeding and the 30 minute whole blood clotting test performed in dry tube were tested in view to propose simple diagnosis and monitoring indicators. It appeared that the combination of the two indicators allowed an early diagnosis of blood incoagulability and a valid monitoring test particularly well adapted to peripheral African health centres. The recommended treatment is intravenous immunotherapy using F(ab')2, renewed in case of persistence of bleedings or a whole blood clotting test higher than 30 minutes. However, the interval between immunotherapy administration renewals remains to be defined.
在喀麦隆北部的苏丹稀树草原地区的一家省级医院开展了一项关于蛇咬伤导致血液凝固性障碍的研究，该医院接收来自距离医院250公里范围内地区的严重中毒患者。对57名自愿参与的患者进行了临床和生物学检查，以确定血液凝固性障碍的病因。该综合征的病因复杂，似乎取决于毒液成分的变异性和/或咬伤与入院之间的时间间隔，从而导致多种生物学体征。此外，鉴于要提出简单的诊断和监测指标，对出血情况以及在干燥试管中进行的30分钟全血凝固试验进行了检测。结果发现，这两项指标的结合能够早期诊断血液凝固性障碍，并且是一种特别适用于非洲周边卫生中心的有效监测测试。推荐的治疗方法是使用F(ab')2进行静脉免疫治疗，若出血持续或全血凝固试验超过30分钟，则需重复治疗。然而，免疫治疗重复给药的间隔时间仍有待确定。
