Downey D J, Omer G E, Moneim M S
Department of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque.
J Trauma. 1991 Oct;31(10):1380-6.
The demographic features, treatment, and outcome of 36 rattlesnake envenomation cases are reviewed. Two populations at special risk are identified: (1) young children (12/36) who sustain lower extremity bites, and (2) adults who consume alcohol and handle snakes (10/36) who sustain upper extremity bites. Antivenin was used in 22 cases with only one serious case of serum sickness. Three definite diagnoses of compartment syndrome were made on the basis of elevated compartment pressures. Hand bites accounted for 20 of the 36 cases. The greatest functional disability followed digit bites in that 11 patients developed decreased motion and sensation. The indications for fasciotomy and debridement are discussed, both for digit and non-digit envenomations. General treatment recommendations are given.
回顾了36例响尾蛇咬伤病例的人口统计学特征、治疗方法及结果。确定了两个特殊风险人群：（1）下肢被咬的幼儿（12/36），以及（2）饮酒且接触蛇的成年人（10/36），他们上肢被咬。22例使用了抗蛇毒血清，仅1例出现严重血清病。根据间隔室压力升高做出了3例明确的骨筋膜室综合征诊断。36例中有20例为手部咬伤。手指咬伤后功能残疾最严重，11例患者出现活动和感觉减退。讨论了手指及非手指咬伤行筋膜切开术和清创术的指征。给出了一般治疗建议。
