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毒蛇咬伤的抽吸:人体模型中“模拟毒液”提取的研究。

Suction for venomous snakebite: a study of "mock venom" extraction in a human model.

作者信息

Alberts Michael B, Shalit Marc, LoGalbo Fred

机构信息

Department of Emergency Medicine, University Medical Center, University of California, San Francisco, Fresno 93702, USA.

出版信息

Ann Emerg Med. 2004 Feb;43(2):181-6. doi: 10.1016/S0196064403008138.

Abstract

STUDY OBJECTIVE

We determine the percentage of mock venom recovered by a suction device (Sawyer Extractor pump) in a simulated snakebite in human volunteers.

METHODS

A mock venom (1 mL normal saline solution, 5.0 mg albumin, 2.5 mg aggregated albumin) radioactively labeled with 1 mCi of technetium was injected with a curved 16-gauge hypodermic needle 1 cm into the right lateral lower leg of 8 supine male volunteers aged 28 to 51 years. The Sawyer Extractor pump was applied after a 3-minute delay, and the blood removed by suction was collected after an additional 15 minutes. A 1991 Siemens Diacam was used to take measurements of the radioactive counts extracted and those remaining in the leg and body.

RESULTS

The "envenomation load," as measured by mean radioactivity in the leg after injection, was 89,895 counts/min. The mean radioactivity found in the blood extracted in the 15 minutes of suction was 38.5 counts/min (95% confidence interval [CI] -33 to 110 counts/min), representing 0.04% of the envenomation load. The postextraction leg count was less than the envenomation load by 1,832 counts/min (95% CI -3,863 to 200 counts/min), representing a 2.0% decrease in the total body venom load.

CONCLUSION

The Sawyer Extractor pump removed bloody fluid from our simulated snakebite wounds but removed virtually no mock venom, which suggests that suction is unlikely to be an effective treatment for reducing the total body venom burden after a venomous snakebite.

摘要

研究目的

我们测定了在人类志愿者模拟蛇咬伤中,一种抽吸装置(索耶提取泵)回收的模拟毒液的百分比。

方法

用一根弯曲的16号皮下注射针,将含有1毫居里锝放射性标记的模拟毒液(1毫升生理盐水溶液、5.0毫克白蛋白、2.5毫克聚合白蛋白)注射到8名年龄在28至51岁的仰卧男性志愿者右下肢外侧1厘米深处。延迟3分钟后应用索耶提取泵,再过15分钟收集抽吸出来的血液。使用一台1991年的西门子Diacam测量提取的放射性计数以及腿部和身体中剩余的放射性计数。

结果

注射后腿部平均放射性所测得的“中毒负荷”为89,895计数/分钟。在抽吸15分钟内提取的血液中测得的平均放射性为38.5计数/分钟(95%置信区间[CI] -33至110计数/分钟),占中毒负荷的0.04%。提取后腿部计数比中毒负荷少1,832计数/分钟(95% CI -3,863至200计数/分钟),表明全身毒液负荷减少了2.0%。

结论

索耶提取泵从我们模拟的蛇咬伤伤口中抽出了血性液体,但几乎没有抽出模拟毒液,这表明抽吸不太可能是减少毒蛇咬伤后全身毒液负担的有效治疗方法。

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