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[蝰蛇(极北蝰)咬伤]

[Viper (Vipera berus) snake bites].

作者信息

Valenta J, Kornalík F

机构信息

Klinika anesteziologie a resuscitace 1. LF UK a VFN, Praha.

出版信息

Cas Lek Cesk. 2000 Jul 19;139(14):419-21.

Abstract

Cases of snake bites (Vipera berus) have as compared with past years a rising trend in the Czech Republic. This ensues among other factors from a higher prevalence of snakes due to the improving ecological situation. The morbidity of snake bites is of no epidemiological importance, the frequency of snake bites amounts to several tens per year and in some clinically manifest intoxication does not develop. Nevertheless in individual cases, in children weakened subjects, a viper bite may be manifested by a serious and in exceptional instances fatal affection. Within the framework of first aid the authors do not recommend application of a tourniquet or dissecting of the wound because of undesirable potentiation of tissue traumatization. Non-specific treatment involves the administration of corticoids and antihistaminics. Specific immunotherapy, administration of horse antiserum (Ipser Europe, Pasteur Mérieux, France) is indicated only in case of systemic or very severe local symptoms and is associated with the risk of a severe allergic reaction. In case of severe systemic symptoms, symptomatic treatment in a health institution of the appropriate type is of fundamental importance. In all cases observation of the affected subject is recommended to rule out intoxication or the development of possible complications.

摘要

与过去几年相比,捷克共和国的蛇咬伤(蝰蛇)病例呈上升趋势。这在其他因素中是由于生态状况改善导致蛇的数量增加。蛇咬伤的发病率没有流行病学意义,每年蛇咬伤的频率为几十例,而且在某些情况下不会出现临床明显的中毒症状。然而,在个别病例中,在儿童和身体虚弱的受试者中,蝰蛇咬伤可能表现为严重的,在特殊情况下甚至是致命的病症。在急救框架内,作者不建议使用止血带或切开伤口,因为这会加重组织创伤。非特异性治疗包括使用皮质类固醇和抗组胺药。特异性免疫疗法,即注射马抗血清(Ipser Europe,法国巴斯德梅里埃公司)仅在出现全身或非常严重的局部症状时使用,并且存在严重过敏反应的风险。在出现严重全身症状的情况下,在适当类型的医疗机构进行对症治疗至关重要。在所有情况下,建议对受影响的受试者进行观察,以排除中毒或可能并发症的发生。

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