White Julian
Toxinology Dept, Women's and Children's Hospital, North Adelaide SA 5006, Australia.
Toxicon. 2005 Jun 15;45(8):951-67. doi: 10.1016/j.toxicon.2005.02.030. Epub 2005 Apr 12.
Snakebite affects around 2.5 million humans annually, with greater than 100,000 deaths. Coagulopathy is a significant cause of both morbidity and mortality in these patients, either directly, or indirectly. This paper reviews clinical aspects of snakebite coagulopathy, including types of coagulopathy (procoagulant, fibrinogen clotting, fibrinolytic, platelet-active, anticoagulant, thrombotic, haemorrhagic), diagnosis and treatment. Examples of clinical laboratory findings in selected types of snakebite coagulopathy are presented. Where available, antivenom is the most effective treatment, while standard treatments for other forms of coagulopathy, such as factor replacement therapy and heparin, are either ineffective or dangerous in snakebite coagulopathy, except in specific situations.
每年约有250万人被蛇咬伤,死亡人数超过10万。凝血病是这些患者发病和死亡的重要原因,可直接或间接导致。本文综述了蛇咬伤凝血病的临床方面,包括凝血病的类型(促凝、纤维蛋白原凝血、纤维蛋白溶解、血小板活性、抗凝、血栓形成、出血性)、诊断和治疗。文中给出了特定类型蛇咬伤凝血病临床实验室检查结果的示例。在可行的情况下,抗蛇毒血清是最有效的治疗方法,而其他形式凝血病的标准治疗方法,如因子替代疗法和肝素,在蛇咬伤凝血病中要么无效,要么危险,特殊情况除外。