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[马来亚眼镜蛇(Naja naja sputatrix)咬伤中毒——病例报告]

[Envenoming by Malayan cobra (Naja naja sputatrix)--case report].

作者信息

Ciszowski Krzysztof, Hartwich Artur

机构信息

Klinika Toksykologii Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.

出版信息

Przegl Lek. 2004;61(4):421-6.

Abstract

Malayan cobra (Naja naja sputatrix) is the venomous snake of the Elapidae family which involves at least three species of Asian spitting cobras, according to the new taxonomy. This snake occurs naturally in southeastern Asia and in Poland it is kept only in the private breedings. Its venom mainly contains neurotoxins which have paralyzing activities to the nervous system and cardiotoxins which act cytolytically. The present study shows a case of the forty-one-year-old man professionally engaging in venomous reptiles who was bitten in his left ring finger by the Malayan cobra. No general symptoms, especially neurotoxic, were observed in the patient after the snake bite, but there was a significant local tissue injury including necrosis. In the bite site the infection with Morganella morganii developed with consequent phlegmon within the hand and the forearm. Additionally, features of haemolysis and injury of muscles with elevated level of serum creatine phosphokinase (CPK) were present. The local injuries of tissues were treated surgically including the amputation of the bitten finger which has undergone the necrosis. No specific antivenom was used in the treatment.

摘要

马来亚眼镜蛇(Naja naja sputatrix)是眼镜蛇科的一种毒蛇,根据新的分类法,该科至少包括三种亚洲喷毒眼镜蛇。这种蛇原产于东南亚,在波兰仅在私人养殖中存在。其毒液主要含有对神经系统有麻痹作用的神经毒素和具有细胞溶解作用的心脏毒素。本研究展示了一例职业从事有毒爬行动物工作的41岁男性被马来亚眼镜蛇咬伤左手无名指的病例。蛇咬后患者未出现一般症状,尤其是神经毒性症状,但出现了明显的局部组织损伤,包括坏死。咬伤部位发生了摩根氏摩根菌感染,随后手部和前臂出现蜂窝织炎。此外,还出现了溶血特征以及血清肌酸磷酸激酶(CPK)水平升高导致的肌肉损伤。对局部组织损伤进行了手术治疗,包括对已坏死的被咬手指进行截肢。治疗过程中未使用特异性抗蛇毒血清。

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