Závada J, Valenta J, Kopecký O, Stach Z, Leden P
Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.
Prague Med Rep. 2011;112(4):298-304.
Although very rare in a European context, a bite from the black mamba Dendroaspis polylepis is an event that poses an immediate threat to life. Given the content of neurotoxins in the snake's venom, the mortality of envenomation reaches 100% in almost every case if ventilation is not provided in a timely manner and adequate therapy initiated. The report describes a case of a snake breeder being envenomed. This 31-year-old man was bitten by a black mamba on his finger, and who subsequently developed clinical symptoms of envenoming typical for the species. Thanks to mechanical ventilation being employed promptly, with myorelaxation during generalized muscle fasciculations, and particularly owing to the eventual antivenin therapy, the patient's condition settled without consequences. In addition to describing the given case in detail, the paper discusses the composition and mechanisms of action of black mamba venom, while providing guidelines for adequate therapy.
在欧洲范围内,黑曼巴蛇(Dendroaspis polylepis)的咬伤极为罕见,但却是一种对生命构成直接威胁的事件。鉴于蛇毒中的神经毒素成分,如果不及时进行通气并启动适当治疗,几乎在每种情况下,中毒后的死亡率都能达到100%。该报告描述了一例蛇饲养员被蛇毒咬伤的病例。这名31岁的男子手指被一条黑曼巴蛇咬伤,随后出现了该物种典型的中毒临床症状。由于及时采用了机械通气,在全身肌肉抽搐时使用了肌松剂,特别是最终进行了抗蛇毒血清治疗,患者的病情得以平稳恢复,未留下后遗症。除了详细描述该病例外,本文还讨论了黑曼巴蛇毒的成分和作用机制,同时提供了适当治疗的指导原则。