Karakus Ali, Zeren Cem, Celik M Murat, Arica Secil, Ozden Raif, Duru Mehmet, Tasın Veyis
Department of Emergency Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
Department of Forensic Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
Toxicol Ind Health. 2015 Feb;31(2):188-92. doi: 10.1177/0748233712472522. Epub 2013 Jan 8.
Snakebites are relatively rare medical emergency cases that might lead to serious consequences. This study aims to evaluate snakebite cases in terms of medical follow-up, antivenom therapy and antivenom reactions. Medical records of patients admitted to emergency department between January 1, 2006 and December 31, 2010 were retrospectively investigated. Snakebite-related cases of a total of 125 patients were included in the scope of the study. Of the total 125 cases, 54.4% were male and 45.6% were female. Most of cases (n: 65, 52%) were aged over 30 years, while the mean age was 34.87 ± 19.29 years. Snakebite-related applications to the emergency department were mostly seen in June with 27 cases. Upon admitting, all patients were recorded to be conscious and showing good general conditions; however, they suffered from pain and edema at the site of bite. Of all, 25 patients only suffered from bite injury and ecchymosis due to snakebite. The site of bite was upper extremities in 66 patients (52.8%), whereas it was lower extremities in 58 (46.4%). Of all, antivenom was unnecessary in 25 (20%) patients, while four antivenoms were administered to each of the 23 (18.4%) patients. Furthermore, six (4.8%) patients needed nine antivenom administrations for each. Anaphylaxis (n: 2, 1.6%), compartment syndrome (n: 2, 1.6%) and serum sickness (n: 1, 0.8%) encountered in remaining cases. Of all, 86 (68.8%) patients were hospitalized in the emergency department, while 25 (20.0%) patients were followed up by observation in emergency service. Only one patient was treated and followed up in intensive care unit. Implementation of antivenom therapy is considered unnecessary for the treatment of all snakebite cases. Antivenom reactions and number of related cases might be reduced by continuous close monitoring, appropriate prophylaxis and controlled slow infusion administration of medications.
蛇咬伤是相对罕见的医疗紧急情况,可能会导致严重后果。本研究旨在从医学随访、抗蛇毒血清治疗及抗蛇毒血清反应方面评估蛇咬伤病例。对2006年1月1日至2010年12月31日期间急诊科收治患者的病历进行回顾性调查。本研究纳入了总共125例与蛇咬伤相关的病例。在这125例病例中,54.4%为男性,45.6%为女性。大多数病例(n = 65,52%)年龄超过30岁,平均年龄为34.87±19.29岁。与蛇咬伤相关的急诊科就诊病例大多出现在6月,有27例。入院时,所有患者均神志清醒且一般情况良好;然而,他们咬伤部位出现疼痛和水肿。其中,25例患者仅因蛇咬伤出现咬伤伤口和瘀斑。咬伤部位在上肢的有66例患者(52.8%),而在下肢的有58例(46.4%)。其中,25例(20%)患者无需使用抗蛇毒血清,而23例(18.4%)患者每人使用了4剂抗蛇毒血清。此外,6例(4.8%)患者每人需要使用9剂抗蛇毒血清。其余病例出现过敏反应(n = 2,1.6%)、骨筋膜室综合征(n = 2,1.6%)和血清病(n = 1,0.8%)。其中,86例(68.8%)患者在急诊科住院,而25例(20.0%)患者在急诊室接受观察随访。只有1例患者在重症监护病房接受治疗和随访。对于所有蛇咬伤病例的治疗,抗蛇毒血清疗法的实施被认为并非必要。通过持续密切监测、适当的预防措施以及控制药物缓慢输注给药,可减少抗蛇毒血清反应及相关病例数量。