Bawaskar H S, Bawaskar P H
Bawaskar Hospital and Research Centre, Mahad, Maharashtra, India.
Ann Trop Paediatr. 1991;11(4):381-7. doi: 10.1080/02724936.1991.11747534.
Scorpion sting in children is a hazardous and potentially fatal condition. Of 34 children admitted to hospital in Mahad, Maharashtra State, India following scorpion sting, 14 had hypertension (130/90-170/130 mmHg), five had myocardial failure, acute pulmonary oedema developed in nine, two had tachycardia (110-200/min) and four died. Analysis of data suggests that cardiovascular morbidity and mortality depend upon the time lapse between sting and administration of vasodilators. Current management of human scorpionism consists of early admission to hospital and immediate reduction of raised blood pressure with sublingual nifedipine while peripheral action of venom is antagonized by the post-synaptic alpha blocker prazosin; in addition, digoxin, frusemide, aminophylline and oxygen are administered. The patient is kept under close surveillance in an intensive care unit. Massive life-threatening pulmonary oedema is treated with a sodium nitroprusside drip. We suggest that aggressive medical management directed at the organ system specifically affected by scorpion venom can be effective.
儿童蝎子蜇伤是一种危险且可能致命的病症。在印度马哈拉施特拉邦马哈德因蝎子蜇伤而入院的34名儿童中，14名患有高血压（130/90 - 170/130 mmHg），5名出现心肌衰竭，9名发生急性肺水肿，2名心动过速（110 - 200次/分钟），4名死亡。数据分析表明，心血管发病率和死亡率取决于蜇伤与使用血管扩张剂之间的时间间隔。目前对人类蝎子蜇伤的治疗包括尽早入院，用舌下硝苯地平立即降低血压升高，同时用突触后α受体阻滞剂哌唑嗪对抗毒液的外周作用；此外，给予地高辛、速尿、氨茶碱和氧气。患者在重症监护病房接受密切监测。对危及生命的大量肺水肿用硝普钠滴注治疗。我们认为，针对蝎子毒液特异性影响的器官系统进行积极的药物治疗可能有效。
