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阿拉伯半岛东南部的陆生蛇咬伤:患者特征、临床表现和治疗。

Terrestrial snakebites in the South East of the Arabian Peninsula: patient characteristics, clinical presentations, and management.

机构信息

Department of Internal Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.

出版信息

PLoS One. 2011;6(9):e24637. doi: 10.1371/journal.pone.0024637. Epub 2011 Sep 12.

Abstract

BACKGROUND

To describe the characteristics, clinical presentations, management and complications of snakebites in the border region between Al-Ain, United Arab Emirates (UAE) and Buraimi, Sultanate of Oman.

METHODOLOGY/PRINCIPAL FINDINGS: We carried out a retrospective review of medical records to study snakebite cases over four-year duration at three tertiary hospitals. Overall, 64 snakebite cases were studied with median hospitalization of 2 (interquartile range [IQR] 1-4) days. The majority of cases were male (87.5%), and most (61%) of the incidents occurred during summer months. The bite sites were predominantly (95%) to the feet and hands. Main clinical features included pain, local swelling, and coagulopathy, blistering and skin peeling. Overall, there were no deaths, but few major complications occurred; extensive skin peeling (n = 5, 8%), multi-organ failure (n = 1, 1.5%), and compartment syndrome (n = 1, 1.5%). Polyvalent anti snake venom (ASV), analgesia, tetanus toxoid, intravenous fluids, and antibiotics such as ampicillin, cloxacillin, and cephalosporins were commonly instituted as part of treatment protocols in the three hospitals.

CONCLUSION

The overwhelming majority of bites occurred during summer months, and envenomations were more common in, relatively, young male farmers, but with no serious clinical complications. Prevention and treatment strategies should include increasing public awareness, developing management guidelines, and manufacturing specific ASV for a wide spectrum of the local venomous snakes.

摘要

背景

描述阿联酋艾因市和阿曼布尔米地区边境地区蛇咬伤的特征、临床表现、处理和并发症。

方法/主要发现:我们对三家三级医院四年间的蛇咬伤病例进行了回顾性病历研究。共有 64 例蛇咬伤病例,中位住院时间为 2 天(四分位距 [IQR] 1-4 天)。大多数病例为男性(87.5%),大多数(61%)事件发生在夏季。咬伤部位主要是(95%)脚部和手部。主要临床特征包括疼痛、局部肿胀和凝血功能障碍、水疱和皮肤剥落。总体上没有死亡病例,但少数出现严重并发症;广泛皮肤剥落(n = 5,8%)、多器官功能衰竭(n = 1,1.5%)和筋膜间室综合征(n = 1,1.5%)。多价抗蛇毒血清(ASV)、镇痛、破伤风类毒素、静脉输液以及氨苄西林、氯唑西林和头孢菌素等抗生素通常作为三家医院治疗方案的一部分。

结论

绝大多数咬伤发生在夏季,相对年轻的男性农民更容易发生中毒,但没有严重的临床并发症。预防和治疗策略应包括提高公众意识、制定管理指南以及为当地多种毒蛇制造特定的 ASV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/242a/3171447/9f6052bcffdf/pone.0024637.g001.jpg

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