Wang Wei, Chen Quan-Fang, Yin Rui-Xing, Zhu Ji-Jin, Li Qi-Bin, Chang Hai-Hua, Wu Yan-Bi, Michelson Edward
Department of Emergency, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China.
Department of Respiratory, the First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi, China.
Environ Toxicol Pharmacol. 2014 Mar;37(2):648-55. doi: 10.1016/j.etap.2013.12.018. Epub 2014 Jan 29.
Although Chinese cobra snakebite is the most common type of snake venenation in China, it still lacks a comprehensive and systematic description. Hence, we aimed to study Chinese cobra bite cases with particular attention to demography, epidemiology and clinical profile. In this study, a total of 292 cases of Chinese cobra snakebite, presenting between January 1, 2008 and December 31, 2012, were retrospectively reviewed. To investigate the effect of treatment at different presentation times (time from snakebite to admission), the patients were divided into two groups: group A included 133 cases that presented <12 h after the bite; group B included 159 cases that presented ≥12 h after the bite. To assess the correlation between application of a tourniquet and skin grafting, the cases were re-divided into two groups according to whether or not a tourniquet was used after the snakebite: tourniquet group (n=220) and non-tourniquet group (n=72). The results showed that Chinese cobra snakebites were most commonly seen during the summer, in the upper limbs, and in males, young adults, and snake-hunters. Group A experienced milder intoxication than group B (P<0.001). The rate of skin grafting was significantly higher in the tourniquet group (20.0%, compared with 9.7% in the non-tourniquet group, P<0.05). The results of this study indicate that anti-cobra venom and swift admission (within 12 h of the snakebite) are recommended for Chinese cobra snakebite. Tourniquet use is not recommended.
尽管在中国，眼镜蛇咬伤是最常见的蛇伤类型，但仍缺乏全面系统的描述。因此，我们旨在研究眼镜蛇咬伤病例，特别关注人口统计学、流行病学和临床特征。在本研究中，回顾性分析了2008年1月1日至2012年12月31日期间共292例眼镜蛇咬伤病例。为了研究不同就诊时间（从蛇咬伤到入院的时间）对治疗效果的影响，将患者分为两组：A组包括133例咬伤后<12小时就诊的病例；B组包括159例咬伤后≥12小时就诊的病例。为了评估使用止血带与植皮之间的相关性，根据蛇咬伤后是否使用止血带将病例重新分为两组：止血带组（n = 220）和非止血带组（n = 72）。结果显示，眼镜蛇咬伤最常见于夏季，上肢，男性、青壮年和捕蛇者。A组中毒程度比B组轻（P<0.001）。止血带组的植皮率显著更高（20.0%，非止血带组为9.7%，P<0.05）。本研究结果表明，对于眼镜蛇咬伤，建议使用抗眼镜蛇毒血清并尽快入院（蛇咬伤后12小时内）。不建议使用止血带。
