Namal Rathnayaka R M M K, Ranathunga P E A N, Kularatne S A M
Intensive Care Unit, Provincial General Hospital, Ratnapura, Sri Lanka; Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Sri Lanka.
Medical Unit, Provincial General Hospital, Ratnapura, Sri Lanka.
Toxicon. 2017 Oct;137:99-105. doi: 10.1016/j.toxicon.2017.07.017. Epub 2017 Jul 21.
Green pit viper is a venomous endemic snake in Sri Lanka. But little is known regarding its envenoming in the country. This study was carried out in order to find out epidemiology and clinical profile of its bites. A series of 17 patients with Sri Lankan Green pit viper (Trimeresurus trigonocephalus) bites was prospectively studied over 4 years. The mean age was 36 ½ years (range 12-61 years) and comprised 14 (82%) males. Except one case, all bites occurred during day time (0600 h-1800 h) due to inadvertent provocation. In 13 cases (76%) bite took place in estates (tea or cinnamon) and 8 patients (47%) were estate workers. The bitten sites were upper limbs in 11 cases (65%) and lower limbs in 6 cases (35%). Ten patients (59%) brought the offending snake to the hospital and one patient was asymptomatic. Sixteen (94%) developed local envenoming features- 16 (94%) local pain and swelling, 6 (35%) local bleeding and lymphadenopathy and blistering in 4 (24%) patients. Systemic envenoming developed in 4 (24%) patients including 3 (18%) with coagulopathy that was treated with fresh frozen plasma. One (6%) patient developed bradycardia. Sri Lankan Green pit viper bites commonly occurs in estates and causes local envenoming frequently and coagulopathy occasionally.
绿蝰蛇是斯里兰卡特有的一种毒蛇。但该国关于其致人中毒的情况却鲜为人知。开展这项研究是为了查明其咬伤的流行病学特征和临床情况。对17例被斯里兰卡绿蝰蛇（竹叶青蝰蛇）咬伤的患者进行了为期4年的前瞻性研究。平均年龄为36.5岁（范围12 - 61岁），其中男性14例（82%）。除1例病例外，所有咬伤均发生在白天（06:00 - 18:00），原因是意外激怒。13例（76%）咬伤发生在种植园（茶园或肉桂园），8例患者（47%）是种植园工人。咬伤部位上肢11例（65%），下肢6例（35%）。10例患者（59%）将肇事蛇带到了医院，1例患者无症状。16例（94%）出现局部中毒症状——16例（94%）局部疼痛和肿胀，6例（35%）局部出血、淋巴结病，4例（24%）患者出现水泡。4例（24%）患者出现全身中毒，其中3例（18%）出现凝血病，接受了新鲜冰冻血浆治疗。1例（6%）患者出现心动过缓。斯里兰卡绿蝰蛇咬伤常见于种植园，常导致局部中毒，偶尔导致凝血病。
