印度北部一家医院的蛇咬伤中毒情况。
Snake envenomation in a north Indian hospital.
作者信息
Sharma N, Chauhan S, Faruqi S, Bhat P, Varma S
机构信息
Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
出版信息
Emerg Med J. 2005 Feb;22(2):118-20. doi: 10.1136/emj.2003.008458.
OBJECTIVES
To study the clinical profile of snake envenomation in a tertiary referral north Indian hospital.
METHODS
Retrospective case note analysis of all cases of snakebite admitted to the medical emergency from January 1997 to December 2001.
RESULTS
Of a total of 142 cases of snakebite there were 86 elapid bites presenting with neuroparalytic symptoms and 52 viper bites having haemostatic abnormalities. Some 60.6% of the cases of snakebite occurred when the patient was asleep. Urban to rural ratio was 1:4.7 and male to female ratio was 4.25:1. Median time to arrival at our hospital after the bite was nine hours and mean duration of hospital stay was eight days. Twenty seven cases had acute renal failure and 75% of all elapid bites required assisted ventilation. Seventeen of 119 patients who received antivenom had an adverse event. The average dose of antivenom was 51.2 vials for elapid bites and 31 vials for viper bites. Overall mortality rate was 3.5%.
CONCLUSION
Snakebites are common in the rural population of developing countries. There is a need to educate the public about the hazards of snakebite, early hospital referral, and treatment.
目的
研究印度北部一家三级转诊医院中蛇咬伤的临床特征。
方法
对1997年1月至2001年12月收治于医疗急救科的所有蛇咬伤病例进行回顾性病例记录分析。
结果
在总共142例蛇咬伤病例中，有86例眼镜蛇科咬伤表现为神经麻痹症状，52例蝰蛇咬伤有止血异常。约60.6%的蛇咬伤病例发生在患者睡眠时。城市与农村病例数之比为1:4.7，男性与女性病例数之比为4.25:1。咬伤后到达我院的中位时间为9小时，平均住院时间为8天。27例出现急性肾衰竭，所有眼镜蛇科咬伤病例中有75%需要辅助通气。119例接受抗蛇毒血清治疗的患者中有17例发生不良事件。眼镜蛇科咬伤的抗蛇毒血清平均剂量为51.2瓶，蝰蛇咬伤为31瓶。总体死亡率为3.5%。
结论
蛇咬伤在发展中国家农村人口中很常见。有必要对公众进行关于蛇咬伤危害、早期转诊至医院及治疗的教育。
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