El Zahran Tharwat, Kazzi Ziad, Chehadeh Ahel Al-Hajj, Sadek Riyad, El Sayed Mazen J
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Emergency Medicine, Emory University, Georgia Poison Center, Atlanta, Georgia.
J Emerg Trauma Shock. 2018 Apr-Jun;11(2):119-124. doi: 10.4103/JETS.JETS_141_16.
Snakebites lead to at least 421,000 envenomations and result in more than 20,000 deaths per year worldwide. Few reports exist in the Mediterranean region. This study describes demographic and clinical characteristics, treatment modalities, and outcomes of snakebites in Lebanon.
This was a retrospective chart review of patients who presented with snakebite complaint to the emergency department between January 2000 and September 2014.
A total of 24 patients were included in this study. The mean age was 34.6 (±16.4) years and 58.3% were males. Local manifestations were documented in 15 (62.5%) patients, systemic effects in 10 (41.7%), hematologic abnormalities in 10 (41.7%), and neurologic effects in 4 (16.7%) patients. Nine patients (37.5%) received antivenom. The median amount of antivenom administered was 40 ml or 4 vials (range: 1-8 vials). About 50% of patients were admitted to the hospital with 75% to an Intensive Care Unit and 25% to a regular bed. All were discharged home with a median hospital length of stay of 4 (interquartile range 11) days. Among those admitted, seven patients (58.3%) had at least one documented complication (compartment syndrome, fasciotomy, intubation, deep vein thrombosis, coagulopathy, acute respiratory distress syndrome, sepsis, congestive heart failure, cellulitis, upper gastrointestinal bleeding, and vaginal bleeding).
Victims of snakebites in Lebanon developed local, systemic, hematologic, or neurologic manifestations. Complications from snakebites were frequent despite antivenom administration. Larger studies are needed to assess the efficacy of available antivenom and to possibly create a local antivenom for the treatment of snakebites in Lebanon.
蛇咬伤每年在全球导致至少42.1万次中毒,并造成2万多人死亡。地中海地区的相关报道很少。本研究描述了黎巴嫩蛇咬伤患者的人口统计学和临床特征、治疗方式及结果。
这是一项对2000年1月至2014年9月间因蛇咬伤主诉到急诊科就诊患者的回顾性病历审查。
本研究共纳入24例患者。平均年龄为34.6(±16.4)岁,58.3%为男性。15例(62.5%)患者有局部表现,10例(41.7%)有全身影响,10例(41.7%)有血液学异常,4例(16.7%)有神经学影响。9例(37.5%)患者接受了抗蛇毒血清治疗。抗蛇毒血清的中位使用量为40毫升或4瓶(范围:1 - 8瓶)。约50%的患者入院,其中75%入住重症监护病房,25%入住普通病房。所有患者均出院回家,中位住院时间为4天(四分位间距为11天)。在入院患者中,7例(58.3%)至少有一项记录在案的并发症(骨筋膜室综合征、筋膜切开术、插管、深静脉血栓形成、凝血病、急性呼吸窘迫综合征、败血症、充血性心力衰竭、蜂窝织炎、上消化道出血和阴道出血)。
黎巴嫩蛇咬伤受害者出现了局部、全身、血液学或神经学表现。尽管使用了抗蛇毒血清,蛇咬伤的并发症仍很常见。需要进行更大规模的研究来评估现有抗蛇毒血清的疗效,并可能研发一种用于治疗黎巴嫩蛇咬伤的本地抗蛇毒血清。