响尾蛇咬伤后出现反复性凝血病并伴有延迟性大量出血。
Recurrent coagulopathy with delayed significant bleeding after crotaline envenomation.
作者信息
O'Brien Nicole F, DeMott Megan C, Suchard Jeffrey R, Clark Richard F, Peterson Bradley M
机构信息
Department of Critical Care, Rady Children's Hospital, San Diego, CA 32123, USA.
出版信息
Pediatr Emerg Care. 2009 Jul;25(7):457-9. doi: 10.1097/PEC.0b013e3181ab7871.
OBJECTIVES
Report of delayed significant coagulopathy, thrombocytopenia, and bleeding after Crotaline envenomation.
METHODS
Recurrent coagulopathy and thrombocytopenia have been described after treatment of Crotaline envenomation with Crotalidae polyvalent immune Fab (CroFab). Until now, there have been no reports of significant spontaneous bleeding despite these abnormalities.
RESULTS
Crotalidae polyvalent immune Fab has a relatively short half-life compared with previous antivenoms used to treat snake bite. This shorter half-life allows for recurrence of venom effects. Therefore, patients with Crotaline envenomation should undergo close monitoring for recurrence of coagulopathy or thrombocytopenia after treatment with CroFab.
CONCLUSIONS
If coagulopathy or thrombocytopenia recurs, retreatment with CroFab should be considered to prevent significant bleeding.
目的
报告响尾蛇咬伤后出现延迟性严重凝血病、血小板减少症和出血情况。
方法
用多价抗蛇毒血清（CroFab）治疗响尾蛇咬伤后，曾有复发性凝血病和血小板减少症的描述。到目前为止，尽管存在这些异常情况，但尚无明显自发性出血的报告。
结果
与以往用于治疗蛇咬伤的抗蛇毒血清相比，多价抗蛇毒血清（CroFab）的半衰期相对较短。这种较短的半衰期会使毒液效应复发。因此，响尾蛇咬伤患者在用CroFab治疗后应密切监测凝血病或血小板减少症的复发情况。
结论
如果凝血病或血小板减少症复发，应考虑再次使用CroFab进行治疗以预防严重出血。
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